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Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes

Ninomiya, Toshiharu, Perkovic, Vlado, De Galan, Bastiaan, Zoungas, Sophia, Pillai, Avinesh, Jardine, Meg, Patel, Anushka, Cass, Alan, Neal, Bruce, Poulter, Neil, Mogensen, Carl-Erik, Cooper, Mark, Marre, Michel, Williams, Bryan, Hamet, Pavel, Mancia, Giusppe, Woodward, Mark, MacMahon, Stephen, Chalmers, John and ADVANCE Collaborative Group (2009). Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. Clinical Journal of the American Society of Nephrology,20(8):1813-1821.

Document type: Journal Article

IRMA ID 84473293xPUB19
Title Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes
Author Ninomiya, Toshiharu
Perkovic, Vlado
De Galan, Bastiaan
Zoungas, Sophia
Pillai, Avinesh
Jardine, Meg
Patel, Anushka
Cass, Alan
Neal, Bruce
Poulter, Neil
Mogensen, Carl-Erik
Cooper, Mark
Marre, Michel
Williams, Bryan
Hamet, Pavel
Mancia, Giusppe
Woodward, Mark
MacMahon, Stephen
Chalmers, John
ADVANCE Collaborative Group
Journal Name Clinical Journal of the American Society of Nephrology
Publication Date 2009
Volume Number 20
Issue Number 8
ISSN 1555-9041   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-68149170224
Start Page 1813
End Page 1821
Total Pages 8
Place of Publication United States
Publisher American Society of Nephrology
HERDC Category C1 - Journal Article (DIISR)
Abstract There are limited data regarding whether albuminuria and reduced estimated GFR (eGFR) are separate and independent risk factors for cardiovascular and renal events among individuals with type 2 diabetes. The Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) study examined the effects of routine BP lowering on adverse outcomes in type 2 diabetes. We investigated the effects of urinary albumin-to-creatinine ratio (UACR) and eGFR on the risk for cardiovascular and renal events in 10,640 patients with available data. During an average 4.3-yr follow-up, 938 (8.8%) patients experienced a cardiovascular event and 107 (1.0%) experienced a renal event. The multivariable-adjusted hazard ratio for cardiovascular events was 2.48 (95% confidence interval 1.74 to 3.52) for every 10-fold increase in baseline UACR and 2.20 (95% confidence interval 1.09 to 4.43) for every halving of baseline eGFR, after adjustment for regression dilution. There was no evidence of interaction between the effects of higher UACR and lower eGFR. Patients with both UACR >300 mg/g and eGFR <60 ml/min per 1.73 m2 at baseline had a 3.2-fold higher risk for cardiovascular events and a 22.2-fold higher risk for renal events, compared with patients with neither of these risk factors. In conclusion, high albuminuria and low eGFR are independent risk factors for cardiovascular and renal events among patients with type 2 diabetes.
DOI http://dx.doi.org/10.1681/ASN.2008121270   (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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