Most Read Articles
11 May 2020
This second issue revisits the impact EMPA-REG OUTCOME had on clinical practice and helps readers discover how it gives life back to patients through its cardiovascular indication. Learn how it was approved and the possible mechanisms for its cardiovascular benefits.
Stephen Padilla, 22 Jul 2019
Zinc supplementation significantly lowers key glycaemic indicators, particularly fasting glucose (FG) in individuals with diabetes and in those who received an inorganic supplement, results of a systematic review and meta-analysis have shown.
Elaine Soliven, 15 Oct 2020

Higher levels of exercise appear to be associated with a lower risk of all-cause mortality in adults with type 2 diabetes (T2D) compared with no exercise at all, according to a study presented at EASD 2020.

Roshini Claire Anthony, 11 Jun 2020

By reducing hepatic enzyme levels and improving markers of hepatic steatosis or fibrosis, bariatric surgery may help reduce the risk of non-alcoholic fatty liver disease (NAFLD), according to a study from Portugal presented at ENDO 2020.

CKD, diabetes, albuminuria: Risk factors for eGFR decline

Audrey Abella
28 Nov 2019
Kenn Daratha, PhD, from the Providence Medical Research Center in Spokane, Washington, US.

Individuals with chronic kidney disease (CKD) had an increased risk of reaching clinically relevant eGFR* decline thresholds compared with individuals who are at risk** for CKD, with diabetes and albuminuria independently predicting this risk, according to data presented at ASN Kidney Week 2019.

The CURE-CKD registry*** included more than 2.6 million participants (aged >18 years, mean baseline eGFR >15 mL/min/1.73 m2), from which four analysis sets were formed to evaluate eGFR declines of 30, 40, and 50 percent from baseline. These thresholds were compared among individuals with CKD vs at risk for CKD (set A; n=1,005,986), CKD patients with vs without diabetes (set B; n=99,936), diabetic CKD patients with vs without albuminuria (set C; n=21,650), and nondiabetic CKD patients with vs without albuminuria (set D; n=78,286). [ASN Kidney Week 2019, SA SA-OR084]

After controlling for potential confounding variables#, analysis of set A revealed that patients with established CKD were independently twice as likely to reach clinically relevant increases in eGFR decline compared with those at risk for CKD (adjusted hazard ratio [adjHR], 1.90, 2.01, and 2.10 for eGFR decline of 30, 40, and 50 percent, respectively; p<0.0001 for all).

Analysis of set B showed that diabetes was an independent predictor of eGFR decline, given the significantly increased risk of eGFR decline among CKD patients with vs without diabetes (adjHR, 1.49, 1.57, and 1.64 for eGFR decline of 30, 40, and 50 percent, respectively; p<0.0001 for all).

Analyses of sets C and D highlighted albuminuria as another independent predictor of eGFR decline, as individuals with albuminuria exhibited greater eGFR decline vs those without albuminuria, both in patients with diabetes (adjHR, 1.40, 1.42, and 1.44) and without diabetes (adjHR, 1.79, 1.90, and 1.96; p<0.0001 for all).

“[The] risk of excess morbidity and mortality steeply increases with decline in eGFR … [hence the need to validate] risk factors for eGFR decline,” said Kenn Daratha, PhD, from the Providence Medical Research Center in Spokane, Washington, US, who presented the findings.

“To our knowledge, this is the largest study to date of clinically representative patients drawing from two large healthcare systems … These data should be used to refine risk stratification for patients with and at risk of CKD and should inform the design of observational studies and randomized clinical trials,” said Daratha.

 

 

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
11 May 2020
This second issue revisits the impact EMPA-REG OUTCOME had on clinical practice and helps readers discover how it gives life back to patients through its cardiovascular indication. Learn how it was approved and the possible mechanisms for its cardiovascular benefits.
Stephen Padilla, 22 Jul 2019
Zinc supplementation significantly lowers key glycaemic indicators, particularly fasting glucose (FG) in individuals with diabetes and in those who received an inorganic supplement, results of a systematic review and meta-analysis have shown.
Elaine Soliven, 15 Oct 2020

Higher levels of exercise appear to be associated with a lower risk of all-cause mortality in adults with type 2 diabetes (T2D) compared with no exercise at all, according to a study presented at EASD 2020.

Roshini Claire Anthony, 11 Jun 2020

By reducing hepatic enzyme levels and improving markers of hepatic steatosis or fibrosis, bariatric surgery may help reduce the risk of non-alcoholic fatty liver disease (NAFLD), according to a study from Portugal presented at ENDO 2020.