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August 28, 2019PLoS ONEOpen Access

Reduced eGFR and proteinuria were independently associated with increased risk of MACE regardless of diabetes status, but the risk of MACE in the same eGFR state was 4.6-2.4 times higher in T2DM than in non-DM.

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Why the study?

Diabetes plays an important role in the complex relationship between chronic kidney disease and cardiovascular disease, but the influence of eGFR and proteinuria on MACE risk across diabetes status needed comparison.

Population

CKD patients without prior MACE classified as T1DM (n = 164), T2DM (n = 9,711), and non-DM (n = 75,789)

Comparison

eGFR and proteinuria categories in CKD patients with vs without diabetes

Design

Retrospective observational study

Authors

CCCraig J. CurrieEBEllen BerniTBThomas R. Berni

Discussion

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Overview

Diabetes amplifies MACE risk at equivalent eGFR in CKD; extends observational data on independent predictors but leaves practice change open.

Structured PICO

P
Population
85,664 individuals with chronic kidney disease (CKD) and no prior MACE from a UK electronic health records database, classified as type 1 diabetes (n=164), type 2 diabetes (n=9,711), and non-diabetes (n=75,789).
O
Outcome
Major adverse cardiovascular event (MACE; myocardial infarction or stroke)composite

In patients with CKD, reduced eGFR and proteinuria independently increase MACE risk, but this risk is substantially amplified in the presence of type 2 diabetes.

Limitations

  • Low numbers in T1DM precluded analysis

Cite This Study

Currie et al. (2019) studied this question.

synapsesocial.com/papers/6a927fe58262cd83d9622f38https://doi.org/10.1371/journal.pone.0221044
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiorenal prognosis by residual proteinuria level in diabetic chronic kidney disease: pooled analysis of four cohort studies2018 · 91 citations
  2. 2Kidney Measures with Diabetes and Hypertension on Cardiovascular Disease: The Atherosclerosis Risk in Communities Study2015 · 22 citations
  3. 3Cardiovascular events and mortality in chronic kidney disease in primary care patients with previous type 2 diabetes and/or hypertension. A population-based epidemiological study (KIDNEES)2022 · 10 citations
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  5. 5Characteristics of the Relationship of Kidney Dysfunction with Cardiovascular Disease in High Risk Patients with Diabetes2016 · 2 citations