Key result
Higher aldosterone-to-renin ratio in T2D is linked to increased urinary albumin excretion and decreased eGFR.
Why the study?
Although primary aldosteronism and the aldosterone-to-renin ratio are linked to kidney disease, their relationship with urinary albumin excretion and eGFR in type 2 diabetes required investigation.
Is the aldosterone-to-renin ratio associated with markers of diabetic nephropathy in patients with type 2 diabetes?
Observational (n=70)
No
Is the aldosterone-to-renin ratio associated with markers of diabetic nephropathy in patients with type 2 diabetes?
Effect estimate: r=0.37
p-value: p=<0.001
A higher aldosterone-to-renin ratio, even below the threshold for primary aldosteronism, is associated with increased urinary albumin excretion and decreased eGFR in patients with type 2 diabetes.
BACKGROUND It is well established that primary aldosteronism (PA) and aldosterone-to-renin ratio (ARR) are associated with kidney disease. The aim of this study was to retrospectively investigate the relationship between ARR, urinary albumin excretion (UAE), and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes from a single center. MATERIAL AND METHODS We included 70 patients with type 2 diabetes, UAE ≤100 mg/day, not taking renin-aldosterone system inhibitors, did not meet the diagnostic criteria for PA, and had an ARR <20. The patients were divided into 3 groups: the normal low (NL) group (33 patients) with a UAE <10 mg/day, the normal (N) group (22 patients) with a UAE of 10-29 mg/day, and the microalbuminuria (M) group (15 patients) with a UAE of 30-100 mg/day. The ARR, plasma renin activity (PRA), and plasma aldosterone (PAC) were compared among groups. RESULTS The ARR was highest in group M (10.1±4.6), 6.5±0.3 in group NL, and 7.0±2.7 in group N. The PRA and PAC were significantly lower in group M (P<0.001). The ARR showed a significant positive correlation with log UAE (r=0.37, P<0.001) and a significant negative correlation with eGFR (r=-0.33, P<0.01). CONCLUSIONS High levels of aldosterone relative to renin, which did not fulfill confirmatory criteria for PA, may be one of the risk factors for the development of diabetic nephropathy in patients with diabetes. The present results are supported by previous research showing that an increased ARR without PA was a risk factor for kidney disease.
No takes yet. Share an insight, caveat, or question.
A 2022 study conducted an observational in Type 2 diabetes mellitus (n=70). Aldosterone-to-Renin Ratio (ARR) vs. Lower ARR / Normal UAE was evaluated on Correlation between ARR and log urinary albumin excretion (UAE) (r=0.37, p=<0.001). In patients with type 2 diabetes, a higher aldosterone-to-renin ratio was significantly correlated with increased urinary albumin excretion (r=0.37, P<0.001) and decreased eGFR (r=-0.33, P<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: