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Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes.
Clin Exp Nephrol 2014; 18(4):613-20CE

Abstract

BACKGROUND

The number of patients suffering from diabetic nephropathy resulting in end-stage kidney disease is increasing worldwide. In clinical settings, there are limited data regarding the impact of the urinary albumin-to-creatinine ratio (UACR) and reduced estimated glomerular filtration rate (eGFR) on renal and cardiovascular outcomes and all-cause mortality.

METHODS

We performed a historical cohort study of 4328 Japanese participants with type 2 diabetes from 10 centers. Risks for renal events (requirement for dialysis or transplantation, or half reduction in eGFR), cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke), and all-cause mortality were assessed according to UACR and eGFR levels.

RESULTS

During follow-up (median 7.0 years, interquartile range 3.0-8.0 years), 419 renal events, 605 cardiovascular events and 236 deaths occurred. The UACR levels increased the risk and the adjusted hazard ratios for these three events. In addition to the effects of UACR levels, eGFR stages significantly increased the adjusted hazard ratios for renal events and all-cause mortality, especially in patients with macroalbuminuria. Diabetic nephropathy score, based on the prognostic factors, well predicted incidence rates per 1000 patient/year for each event.

CONCLUSIONS

Increased UACR levels were closely related to the increase in risks for renal, cardiovascular events and all-cause mortality in Japanese patients with type 2 diabetes, whereas the association between high levels of UACR and reduced eGFR was a strong predictor for renal events.

Authors+Show Affiliations

Division of Nephrology, Kanazawa University Hospital, Kanazawa, Japan, twada@m-kanazawa.jp.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24132561

Citation

Wada, Takashi, et al. "Clinical Impact of Albuminuria and Glomerular Filtration Rate On Renal and Cardiovascular Events, and All-cause Mortality in Japanese Patients With Type 2 Diabetes." Clinical and Experimental Nephrology, vol. 18, no. 4, 2014, pp. 613-20.
Wada T, Haneda M, Furuichi K, et al. Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes. Clin Exp Nephrol. 2014;18(4):613-20.
Wada, T., Haneda, M., Furuichi, K., Babazono, T., Yokoyama, H., Iseki, K., ... Makino, H. (2014). Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes. Clinical and Experimental Nephrology, 18(4), pp. 613-20. doi:10.1007/s10157-013-0879-4.
Wada T, et al. Clinical Impact of Albuminuria and Glomerular Filtration Rate On Renal and Cardiovascular Events, and All-cause Mortality in Japanese Patients With Type 2 Diabetes. Clin Exp Nephrol. 2014;18(4):613-20. PubMed PMID: 24132561.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical impact of albuminuria and glomerular filtration rate on renal and cardiovascular events, and all-cause mortality in Japanese patients with type 2 diabetes. AU - Wada,Takashi, AU - Haneda,Masakazu, AU - Furuichi,Kengo, AU - Babazono,Tetsuya, AU - Yokoyama,Hiroki, AU - Iseki,Kunitoshi, AU - Araki,Shin-ichi, AU - Ninomiya,Toshiharu, AU - Hara,Shigeko, AU - Suzuki,Yoshiki, AU - Iwano,Masayuki, AU - Kusano,Eiji, AU - Moriya,Tatsumi, AU - Satoh,Hiroaki, AU - Nakamura,Hiroyuki, AU - Shimizu,Miho, AU - Toyama,Tadashi, AU - Hara,Akinori, AU - Makino,Hirofumi, AU - ,, Y1 - 2013/10/17/ PY - 2013/08/03/received PY - 2013/09/21/accepted PY - 2013/10/18/entrez PY - 2013/10/18/pubmed PY - 2016/4/15/medline SP - 613 EP - 20 JF - Clinical and experimental nephrology JO - Clin. Exp. Nephrol. VL - 18 IS - 4 N2 - BACKGROUND: The number of patients suffering from diabetic nephropathy resulting in end-stage kidney disease is increasing worldwide. In clinical settings, there are limited data regarding the impact of the urinary albumin-to-creatinine ratio (UACR) and reduced estimated glomerular filtration rate (eGFR) on renal and cardiovascular outcomes and all-cause mortality. METHODS: We performed a historical cohort study of 4328 Japanese participants with type 2 diabetes from 10 centers. Risks for renal events (requirement for dialysis or transplantation, or half reduction in eGFR), cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke), and all-cause mortality were assessed according to UACR and eGFR levels. RESULTS: During follow-up (median 7.0 years, interquartile range 3.0-8.0 years), 419 renal events, 605 cardiovascular events and 236 deaths occurred. The UACR levels increased the risk and the adjusted hazard ratios for these three events. In addition to the effects of UACR levels, eGFR stages significantly increased the adjusted hazard ratios for renal events and all-cause mortality, especially in patients with macroalbuminuria. Diabetic nephropathy score, based on the prognostic factors, well predicted incidence rates per 1000 patient/year for each event. CONCLUSIONS: Increased UACR levels were closely related to the increase in risks for renal, cardiovascular events and all-cause mortality in Japanese patients with type 2 diabetes, whereas the association between high levels of UACR and reduced eGFR was a strong predictor for renal events. SN - 1437-7799 UR - https://www.unboundmedicine.com/medline/citation/24132561/Clinical_impact_of_albuminuria_and_glomerular_filtration_rate_on_renal_and_cardiovascular_events_and_all_cause_mortality_in_Japanese_patients_with_type_2_diabetes_ L2 - https://dx.doi.org/10.1007/s10157-013-0879-4 DB - PRIME DP - Unbound Medicine ER -