January 1, 2019Diabetes & Metabolism JournalOpen Access

Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function

Q: What are the key findings of this study?

The presence of carotid plaque was independently associated with a more than twofold increased risk of rapid renal function decline (OR 2.33) in patients with type 2 diabetes mellitus and preserved renal function.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes mellitus with preserved renal function (n=967). Intervention: Presence of carotid plaque vs. Absence of carotid plaque. Primary outcome: Rapid renal function decline (eGFR decline >3.3% per year) (OR 2.33, 95% CI 1.48-3.68, p=<0.0001).

Q: What does this research mean for the field?

The presence of carotid plaque is independently associated with a more than twofold increased risk of rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Carotid plaque linked to ~133% greater risk of rapid renal decline in T2DM.

OR 2.33
95% CI 1.48-3.68
P<0.0001
n=967

Why the study?

Early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease, but its association with carotid atherosclerosis in type 2 diabetes patients with preserved renal function was unclear.

Does the presence of carotid plaque predict rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function?

Population

967 patients with type 2 diabetes mellitus and preserved renal function

Comparison

Presence of carotid plaque vs absence of carotid plaque

Design

Prospective multicenter cohort study

Follow-up

Median 6 years

Authors

DSDa Hea SeoInha University SKSo Hun KimChonnam National University JSJoon Ho SongInha University

Discussion

Member takes

Overview

Carotid plaque was associated with rapid renal decline in preserved-function T2DM; supports hypothesis-generating risk stratification but should not yet change practice.

Study Design

Type

Cohort (n=967)

Multicenter

Yes

Structured PICO

Does the presence of carotid plaque predict rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function?

Population

967 Korean adults with type 2 diabetes mellitus and preserved renal function were followed for a median of 6 years to assess the association between carotid plaque and rapid renal function decline.

Exposure

Presence of carotid plaque assessed at baseline

Comparator

Absence of carotid plaque

Outcome

Rapid renal function decline (defined as an eGFR decline >3.3% per year) over a median follow-up of 6 yearssurrogate

Main Result

Odds Ratio: 2.33 (95% CI 1.48–3.68)

Absolute Event Rate: 23.2% vs 12.2%

p-value: p=<0.0001

The presence of carotid plaque is an independent predictor of rapid renal function decline in patients with type 2 diabetes and preserved renal function, significantly improving risk discrimination.

Limitations

The cohort comprised Korean patients followed at tertiary-level, university-affiliated hospitals, which may not represent general T2DM populations.
There was no direct measurement of GFR; instead, CKD-EPI equations were used to estimate GFR.
There may have been inter- and intra-observer variability in the measurement of intima-media thickness (IMT) as it was performed by multiple observers.

Cite This Study

Seo et al. (2019) conducted a cohort in Type 2 diabetes mellitus with preserved renal function (n=967). Presence of carotid plaque vs. Absence of carotid plaque was evaluated on Rapid renal function decline (eGFR decline >3.3% per year) (OR 2.33, 95% CI 1.48-3.68, p=<0.0001). The presence of carotid plaque was independently associated with a more than twofold increased risk of rapid renal function decline (OR 2.33) in patients with type 2 diabetes mellitus and preserved renal function.

synapsesocial.com/papers/6aade7089cf7b8608e873dda https://doi.org/10.4093/dmj.2018.0186

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January 1, 2019Diabetes & Metabolism JournalOpen Access

Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function

View Full Paper

Ask AI

Bookmark

Key result

Carotid plaque linked to ~133% greater risk of rapid renal decline in T2DM.

OR 2.33
95% CI 1.48-3.68
P<0.0001
n=967

Why the study?

Does the presence of carotid plaque predict rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function?

Population

967 patients with type 2 diabetes mellitus and preserved renal function

Comparison

Presence of carotid plaque vs absence of carotid plaque

Design

Prospective multicenter cohort study

Follow-up

Median 6 years

Authors

DSDa Hea SeoInha University SKSo Hun KimChonnam National University JSJoon Ho SongInha University

Discussion

Member takes

Overview

Carotid plaque was associated with rapid renal decline in preserved-function T2DM; supports hypothesis-generating risk stratification but should not yet change practice.

Study Design

Type

Cohort (n=967)

Multicenter

Yes

Structured PICO

Does the presence of carotid plaque predict rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function?

Population

967 Korean adults with type 2 diabetes mellitus and preserved renal function were followed for a median of 6 years to assess the association between carotid plaque and rapid renal function decline.

Exposure

Presence of carotid plaque assessed at baseline

Comparator

Absence of carotid plaque

Outcome

Rapid renal function decline (defined as an eGFR decline >3.3% per year) over a median follow-up of 6 yearssurrogate

Main Result

Odds Ratio: 2.33 (95% CI 1.48–3.68)

Absolute Event Rate: 23.2% vs 12.2%

p-value: p=<0.0001

The presence of carotid plaque is an independent predictor of rapid renal function decline in patients with type 2 diabetes and preserved renal function, significantly improving risk discrimination.

Limitations

The cohort comprised Korean patients followed at tertiary-level, university-affiliated hospitals, which may not represent general T2DM populations.
There was no direct measurement of GFR; instead, CKD-EPI equations were used to estimate GFR.
There may have been inter- and intra-observer variability in the measurement of intima-media thickness (IMT) as it was performed by multiple observers.

Cite This Study

synapsesocial.com/papers/6aade7089cf7b8608e873dda https://doi.org/10.4093/dmj.2018.0186

Also Consider

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

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