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

Toshiharu Ninomiya, Vlado Perkovic, Bastiaan E. De Galan, Sophia Zoungas, Avinesh Pillai, Meg Jardine, Anushka Patel, Alan Cass, Bruce Neal, Neil Poulter, Carl Erik Mogensen, Mark Cooper, Michel Marre, Bryan Williams, Pavel Hamet, Giuseppe Mancia, Mark Woodward, Stephen MacMahon, John Chalmers

Research output: Contribution to journalArticle

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

Original languageEnglish (US)
Pages (from-to)1813-1821
Number of pages9
JournalJournal of the American Society of Nephrology
Volume20
Issue number8
DOIs
StatePublished - Aug 2009
Externally publishedYes

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Albuminuria
Albumins
Creatinine
Kidney
perindopril drug combination indapamide
Type 2 Diabetes Mellitus
Gliclazide
Confidence Intervals
Vascular Diseases

ASJC Scopus subject areas

  • Nephrology

Cite this

Ninomiya, T., Perkovic, V., De Galan, B. E., Zoungas, S., Pillai, A., Jardine, M., ... Chalmers, J. (2009). Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. Journal of the American Society of Nephrology, 20(8), 1813-1821. https://doi.org/10.1681/ASN.2008121270

Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. / Ninomiya, Toshiharu; Perkovic, Vlado; De Galan, Bastiaan E.; 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, Giuseppe; Woodward, Mark; MacMahon, Stephen; Chalmers, John.

In: Journal of the American Society of Nephrology, Vol. 20, No. 8, 08.2009, p. 1813-1821.

Research output: Contribution to journalArticle

Ninomiya, T, Perkovic, V, De Galan, BE, Zoungas, S, Pillai, A, Jardine, M, Patel, A, Cass, A, Neal, B, Poulter, N, Mogensen, CE, Cooper, M, Marre, M, Williams, B, Hamet, P, Mancia, G, Woodward, M, MacMahon, S & Chalmers, J 2009, 'Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes', Journal of the American Society of Nephrology, vol. 20, no. 8, pp. 1813-1821. https://doi.org/10.1681/ASN.2008121270
Ninomiya, Toshiharu ; Perkovic, Vlado ; De Galan, Bastiaan E. ; 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, Giuseppe ; Woodward, Mark ; MacMahon, Stephen ; Chalmers, John. / Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. In: Journal of the American Society of Nephrology. 2009 ; Vol. 20, No. 8. pp. 1813-1821.
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