Key result
Persistent albuminuria increased the 4-year risk of >30% eGFR loss or stage 3 chronic kidney disease compared to persistent normal albuminuria (OR 2.00; 95% CI 1.71-2.34; P<0.001).
Why the study?
Does persistent albuminuria predict renal function decline in patients with type 2 diabetes and hypertension?
Cohort (n=12,611)
Yes
Does persistent albuminuria predict renal function decline in patients with type 2 diabetes and hypertension?
Odds Ratio: 2 (95% CI 1.71–2.34)
p-value: p=< 0.001
In patients with type 2 diabetes and hypertension, persistent albuminuria is a strong predictor of renal function decline, suggesting that monitoring albuminuria status can guide therapeutic optimization.
May support albuminuria monitoring for renal risk stratification in T2D hypertension; leaves open whether targeting it alters eGFR decline.
OBJECTIVES: To assess the predictive role of changes in albuminuria on the loss of renal function under antihypertensive treatment in patients with type 2 diabetes (T2D). METHODS: Clinical records from a total of 12 611 patients with hypertension and T2D, attending 100 antidiabetic centers in Italy, with normal estimated glomerular filtration rate (eGFR) at baseline and regular visits during a 4-year period were retrieved and analyzed. We assessed the association between changes in albuminuria status during a 1-year baseline period and time updated blood pressure (BP) and eGFR loss over the subsequent 4-year follow-up. RESULTS: Mean age at baseline was 65 ± 9 years, known duration of diabetes11 ± 8 years, eGFR 85 ± 13 ml/min and BP 142 ± 17/81 ± 9 mmHg. Patients with persistent albuminuria showed the highest 4-year risk of eGFR loss more than 30% from baseline or onset of stage 3 chronic kidney disease (eGFR < 60 ml/min) as compared with those with persistent normal albuminuria (odds ratio 2.00, confidence interval 1.71-2.34; P < 0.001). Female sex, age, disease duration, BMI, low baseline eGFR, lipid profile, the number of antihypertensive drugs and variations in albuminuria status were associated with renal risk in the whole study population. Furthermore, lower time updated BP values and the use of renin-angiotensin-aldosterone-system-inhibitors were related to the occurrence of renal endpoints only in the subgroup of patients without albuminuria. CONCLUSION: In patients with hypertension and T2D under real-life clinical conditions, changes in albuminuria parallel changes of renal risk. Albuminuria status could be a guide to optimize therapeutic strategy.
No takes yet. Share an insight, caveat, or question.
Viazzi et al. (2018) conducted a cohort in Type 2 diabetes and hypertension (n=12,611). Persistent albuminuria vs. Persistent normal albuminuria was evaluated on eGFR loss more than 30% from baseline or onset of stage 3 chronic kidney disease (eGFR < 60 ml/min) (OR 2.00, 95% CI 1.71-2.34, p=< 0.001). Persistent albuminuria increased the 4-year risk of >30% eGFR loss or stage 3 chronic kidney disease compared to persistent normal albuminuria (OR 2.00; 95% CI 1.71-2.34; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: