Key result
In incident hemodialysis patients with diabetes, the lowest quartile of proteinuria (<3.0 g/gCr) was associated with a greater risk of atherosclerotic cardiovascular disease compared to the third quartile (SHR 2.04).
Why the study?
The clinical implications of proteinuria levels at the start of dialysis have not been confirmed in patients with diabetic kidney disease.
Does lower proteinuria at dialysis initiation predict atherosclerotic cardiovascular disease in incident hemodialysis patients with diabetes?
Population
361 incident hemodialysis patients with diabetes
Comparison
Proteinuria quartiles at dialysis initiation
Design
Retrospective multicenter cohort study
Authors
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May warrant closer ASCVD monitoring in low-proteinuria diabetic HD patients; leaves open whether it refines risk stratification.
Cohort (n=361)
Yes
Does lower proteinuria at dialysis initiation predict atherosclerotic cardiovascular disease in incident hemodialysis patients with diabetes?
Hazard Ratio: 2.04 (95% CI 1–4.14)
p-value: p=0.049
In incident hemodialysis patients with diabetes, lower proteinuria at dialysis initiation is associated with a higher risk of atherosclerotic cardiovascular disease, reflecting more severe underlying macroangiopathy.
Yamaguchi et al. (2022) conducted a cohort in Diabetic kidney disease (n=361). Lowest quartile of proteinuria (<3.0 g/gCr) vs. Third quartile of proteinuria (5.4-8.8 g/gCr) was evaluated on Fatal atherosclerotic CVD and re-hospitalization for atherosclerotic CVD (SHR 2.04, 95% CI 1.00-4.14, p=0.049). In incident hemodialysis patients with diabetes, the lowest quartile of proteinuria (<3.0 g/gCr) was associated with a greater risk of atherosclerotic cardiovascular disease compared to the third quartile (SHR 2.04).
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