Achieving a 50% reduction in microalbuminuria in type 2 diabetic patients was associated with a significantly lower risk of renal or cardiovascular events (adjusted risk 0.41; 95% CI 0.15-0.96).
Observational (n=216)
Does achieving a 50% reduction in microalbuminuria reduce the risk of renal or cardiovascular events in type 2 diabetic patients with microalbuminuria?
Achieving a 50% reduction in microalbuminuria is associated with a significantly lower risk of subsequent renal and cardiovascular events in patients with type 2 diabetes.
Effect estimate: adjusted risk 0.41 (95% CI 0.15-0.96)
Absolute Event Rate: 12.9% vs 28.5%
OBJECTIVE: Microalbuminuria in diabetic patients is a predictor for diabetic nephropathy and cardiovascular disease. The aim of this study is to investigate the clinical impact of reducing microalbuminuria in type 2 diabetic patients in an observational follow-up study. RESEARCH DESIGN AND METHODS: We enrolled 216 type 2 diabetic patients with microalbuminuria during an initial 2-year evaluation period and observed them for the next 8 years. Remission and a 50% reduction of microalbuminuria were defined as a shift to normoalbuminuria and a reduction <50% from the initial level of microalbuminuria. The association between reducing microalbuminuria and first occurrence of a renal or cardiovascular event and annual decline rate of estimated glomerular filtration rate (eGFR) was evaluated. RESULTS: Twelve events occurred in 93 patients who attained a 50% reduction of microalbuminuria during the follow-up versus 35 events in 123 patients without a 50% reduction. The cumulative incidence rate of events was significantly lower in patients with a 50% reduction. A pooled logistic regression analysis revealed that the adjusted risk for events in subjects after a 50% reduction was 0.41 (95% CI 0.15-0.96). In addition, the annual decline rate of eGFR in patients with a 50% reduction was significantly slower than in those without such a reduction. The same results were also found in the analysis regarding whether remission occurred. CONCLUSIONS: The present study provides clinical evidence implying that a reduction of microalbuminuria in type 2 diabetic patients is an integrated indicator for renal and cardiovascular risk reduction.
Araki et al. (Sat,) conducted a observational in Type 2 diabetes with microalbuminuria (n=216). 50% reduction of microalbuminuria vs. No 50% reduction of microalbuminuria was evaluated on First occurrence of a renal or cardiovascular event (adjusted risk 0.41, 95% CI 0.15-0.96). Achieving a 50% reduction in microalbuminuria in type 2 diabetic patients was associated with a significantly lower risk of renal or cardiovascular events (adjusted risk 0.41; 95% CI 0.15-0.96).
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