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Intensive glucose control improves kidney outcomes in patients with type 2 diabetes

Perkovic, Vlado, Heerspink, Hiddo, Chalmers, John, Woodward, Mark, Jun, Min, Li, Qiang, MacMahon, S, Cooper, Mark, Hamet, Pavel, Marre, Michel, Mogensen, Carl, Poulter, Neil, Mancia, Giuseppe, Cass, Alan, Patel, Anushka, Zoungas, Sophia and ADVANCE Collaborative Group (2013). Intensive glucose control improves kidney outcomes in patients with type 2 diabetes. Kidney International,83(3):517-523.

Document type: Journal Article

IRMA ID 11035xPUB67
Title Intensive glucose control improves kidney outcomes in patients with type 2 diabetes
Author Perkovic, Vlado
Heerspink, Hiddo
Chalmers, John
Woodward, Mark
Jun, Min
Li, Qiang
MacMahon, S
Cooper, Mark
Hamet, Pavel
Marre, Michel
Mogensen, Carl
Poulter, Neil
Mancia, Giuseppe
Cass, Alan
Patel, Anushka
Zoungas, Sophia
ADVANCE Collaborative Group
Journal Name Kidney International
Publication Date 2013
Volume Number 83
Issue Number 3
ISSN 0085-2538   (check CDU catalogue open catalogue search in new window)
Start Page 517
End Page 523
Total Pages 7
Place of Publication United States
Publisher Elsevier Inc.
HERDC Category C1 - Journal Article (DIISR)
Abstract The effect of intensive glucose control on major kidney outcomes in type 2 diabetes remains unclear. To study this, the ADVANCE trial randomly assigned 11,140 participants to an intensive glucose-lowering strategy (hemoglobin A1c target 6.5% or less) or standard glucose control. Treatment effects on end-stage renal disease ((ESRD), requirement for dialysis or renal transplantation), total kidney events, renal death, doubling of creatinine to above 200 μmol/l, new-onset macroalbuminuria or microalbuminuria, and progression or regression of albuminuria, were then assessed. After a median of 5 years, the mean hemoglobin A1c level was 6.5% in the intensive group, and 7.3% in the standard group. Intensive glucose control significantly reduced the risk of ESRD by 65% (20 compared to 7 events), microalbuminuria by 9% (1298 compared to 1410 patients), and macroalbuminuria by 30% (162 compared to 231 patients). The progression of albuminuria was significantly reduced by 10% and its regression significantly increased by 15%. The results were almost identical in analyses taking account of potential competing risks. The number of participants needed to treat over 5 years to prevent one ESRD event ranged from 410 in the overall study to 41 participants with macroalbuminuria at baseline. Thus, improved glucose control will improve major kidney outcomes in patients with type 2 diabetes.
DOI http://dx.doi.org/10.1038/ki.2012.401   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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