|The following article features coverage from the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings. Click here to read more of Renal and Urology News’ conference coverage.|
Over the past 20 years, the prevalence of albuminuria has decreased while kidney function decline has increased. Still, rates of diabetic kidney disease have remained the same. In a poster presentation at the live virtual National Kidney Foundation 2020 Spring Clinical Meetings, investigators report that better glycemic control correlates with less albuminuria but not improved estimated glomerular filtration rate (eGFR).
Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the University of California Irvine, and collaborators stratified 5647 self-reported diabetes patients from the National Health and Nutrition Examination Survey (1999-2016) by their level of glycemic control – good (A1c less than 7%), intermediate (A1c 7%-9%), and, poor (A1c 9% or more) – and by their clinical manifestation of kidney disease.
More patients with good glycemic control displayed only an eGFR less than 60 mL/min/1.73 m2, whereas more patients with poor glycemic control displayed only a urinary albumin-to-creatinine ratio (UACR) less than 30 mg/g. In adjusted multivariable linear regression models excluding hyperfiltration cases, A1c only significantly correlated with albuminuria.
“This study demonstrated that better glycemic control is associated with decreased albuminuria among patients with diabetes, but not with improved eGFR level,” lead author Mitra Mosslemi, MSc, told Renal & Urology News. “Our results highlight the importance of following diabetes screening recommendations to track eGFR along with albuminuria routinely, even in patients with optimal glycemic control.”
The team is currently working on another study characterizing the differences between normoalbuminuric and albuminuric CKD in patients with diabetes. The preliminary results are scheduled to be released at the American Diabetes Association Scientifics Sections in June 2020. They also plan to investigate alternative diagnostic markers for detecting diabetic kidney disease in the absence of albuminuria.
Read more of our coverage of the National Kidney Foundation’s virtual 2020 Spring Clinical Meetings by visiting the conference page.
Mosslemi M, Wenziger C, Hsiung J-T, Kalantar-Zadeh K, Rhee C, Hanna R, Streja E. Association of glycemic control level with the clinical manifestation of kidney injury among patients with diagnosed diabetes. Data presented at the live virtual National Kidney Foundation 2020 Spring Clinical Meetings held March 25 to 29. ePoster 311.