Dataset Information

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes.

ABSTRACT:

Background

Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ?3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ?3 CKD in a large cohort of patients affected by T1DM.

Methods

A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage ?3 CKD (eGFR ?30% from baseline was evaluated.

Results

The mean estimated GFR was 98?±?17?mL/min/1.73m² and the proportion of patients with albuminuria was 15.3% (n?=?654) at baseline. About 8% (n?=?337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR 2 were independent risk factors for stage ?3 CKD and renal function worsening. When compared to patients with eGFR >?90?ml/min/1.73m² and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60?mL/min/1.73?m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline.

Conclusions

Albuminuria and eGFR reduction represent independent risk factors for incident stage ?3 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening.

SUBMITTER: Mirijello A

PROVIDER: S-EPMC6280443 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes.

Mirijello Antonio A Viazzi Francesca F Fioretto Paola P Giorda Carlo C Ceriello Antonio A Russo Giuspina T GT Guida Pietro P Pontremoli Roberto R De Cosmo Salvatore S

BMC nephrology 20181204 1

<h4>Background</h4>Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage ≥3 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage ≥3 CKD in a large cohor ...[more]

PMID: 30514308

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Dataset Information

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes.

Background

Methods

Results

Conclusions

Publications

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes.

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