Increased risk of renal deterioration associated with low e-GFR in type 2 diabetes mellitus only in albuminuric subjects

Shu Meguro, Toshikatsu Shigihara, Yusuke Kabeya, Masuomi Tomita, Yoshihito Atsumi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: The significance of estimated glomerular filtration rate (e-GFR) in diabetic nephropathy has yet to be clearly determined. We therefore compared albuminuria and e-GFR for usefulness in predicting progressive decline in renal function. Methods: A total of 1,303 subjects with type 2 diabetes mellitus whose e-GFR was more than 30 mL/min/1.73 m2 were followed for three years. Associations of clinical staging based on AER and that based on e-GFR with progression of renal insufficiency (e-GFR <30 mL/min/1.73 m2) were evaluated. Results: On univariate analysis, both clinical stages based on e-GFR and AER were significant variables (p< 0.05). On multiple logistic regression analysis, the odds ratio for macroalbuminuria was 132.3, and that for microalbuminuria was 10.3 while that for e-GFR less than 60 mL/ min/1.73 m2 was 9.0 for further deterioration of renal function. On the other hand, subjects without albuminuria exhibited a rate of disease progression of less than 1% irrespective of e-GFR level. Conclusions: Both albuminuria and reduced e-GFR are significant and independent risk factors for further deterioration of diabetic nephropathy, though albuminuria had a greater odds ratio than reduced e-GFR for deterioration of renal function over a three-year period, e-GFR exhibited additive risk for deterioration of diabetic nephropathy within three years only when albuminuria was present.

Original languageEnglish
Pages (from-to)657-663
Number of pages7
JournalInternal Medicine
Volume48
Issue number9
DOIs
Publication statusPublished - 2009
Externally publishedYes

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Glomerular Filtration Rate
Type 2 Diabetes Mellitus
Kidney
Albuminuria
Diabetic Nephropathies
Odds Ratio
Renal Insufficiency
Disease Progression
Logistic Models
Regression Analysis

Keywords

  • Albuminuria
  • Chronic kidney disease
  • Diabetic nephropathy
  • Risk factor

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Increased risk of renal deterioration associated with low e-GFR in type 2 diabetes mellitus only in albuminuric subjects. / Meguro, Shu; Shigihara, Toshikatsu; Kabeya, Yusuke; Tomita, Masuomi; Atsumi, Yoshihito.

In: Internal Medicine, Vol. 48, No. 9, 2009, p. 657-663.

Research output: Contribution to journalArticle

Meguro, Shu ; Shigihara, Toshikatsu ; Kabeya, Yusuke ; Tomita, Masuomi ; Atsumi, Yoshihito. / Increased risk of renal deterioration associated with low e-GFR in type 2 diabetes mellitus only in albuminuric subjects. In: Internal Medicine. 2009 ; Vol. 48, No. 9. pp. 657-663.
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AU - Tomita, Masuomi

AU - Atsumi, Yoshihito

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N2 - Objective: The significance of estimated glomerular filtration rate (e-GFR) in diabetic nephropathy has yet to be clearly determined. We therefore compared albuminuria and e-GFR for usefulness in predicting progressive decline in renal function. Methods: A total of 1,303 subjects with type 2 diabetes mellitus whose e-GFR was more than 30 mL/min/1.73 m2 were followed for three years. Associations of clinical staging based on AER and that based on e-GFR with progression of renal insufficiency (e-GFR <30 mL/min/1.73 m2) were evaluated. Results: On univariate analysis, both clinical stages based on e-GFR and AER were significant variables (p< 0.05). On multiple logistic regression analysis, the odds ratio for macroalbuminuria was 132.3, and that for microalbuminuria was 10.3 while that for e-GFR less than 60 mL/ min/1.73 m2 was 9.0 for further deterioration of renal function. On the other hand, subjects without albuminuria exhibited a rate of disease progression of less than 1% irrespective of e-GFR level. Conclusions: Both albuminuria and reduced e-GFR are significant and independent risk factors for further deterioration of diabetic nephropathy, though albuminuria had a greater odds ratio than reduced e-GFR for deterioration of renal function over a three-year period, e-GFR exhibited additive risk for deterioration of diabetic nephropathy within three years only when albuminuria was present.

AB - Objective: The significance of estimated glomerular filtration rate (e-GFR) in diabetic nephropathy has yet to be clearly determined. We therefore compared albuminuria and e-GFR for usefulness in predicting progressive decline in renal function. Methods: A total of 1,303 subjects with type 2 diabetes mellitus whose e-GFR was more than 30 mL/min/1.73 m2 were followed for three years. Associations of clinical staging based on AER and that based on e-GFR with progression of renal insufficiency (e-GFR <30 mL/min/1.73 m2) were evaluated. Results: On univariate analysis, both clinical stages based on e-GFR and AER were significant variables (p< 0.05). On multiple logistic regression analysis, the odds ratio for macroalbuminuria was 132.3, and that for microalbuminuria was 10.3 while that for e-GFR less than 60 mL/ min/1.73 m2 was 9.0 for further deterioration of renal function. On the other hand, subjects without albuminuria exhibited a rate of disease progression of less than 1% irrespective of e-GFR level. Conclusions: Both albuminuria and reduced e-GFR are significant and independent risk factors for further deterioration of diabetic nephropathy, though albuminuria had a greater odds ratio than reduced e-GFR for deterioration of renal function over a three-year period, e-GFR exhibited additive risk for deterioration of diabetic nephropathy within three years only when albuminuria was present.

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