Diabetic Kidney Disease Without Albuminuria Ups CKD Progression Risk

Patients with diminished estimated glomerular filtration rate (eGFR) alone and no albuminuria had a nearly 2.4-fold increased risk for a composite renal outcome of incident end-stage kidney disease or sustained eGFR reduction of 40% or greater, a study found.

Diabetic kidney disease (DKD) without albuminuria is significantly associated with higher risks for progression of chronic kidney disease (CKD), hospitalization for heart failure, and death, according to data published in the American Journal of Kidney Diseases.

The findings emerged from a study of 19,025 Chinese adults with type 2 diabetes enrolled in the Hong Kong Diabetes Biobank. Compared with patients who did not have DKD, those with a decreased estimated glomerular filtration rate (eGFR) only, albuminuria only, and albuminuria plus decreased eGFR had 2.4-, 3.8-, and 14.0-fold increased risks for a composite renal outcome of incident end-stage kidney disease or sustained eGFR reduction of 40% or greater, respectively, after adjusting for confounders, Ronald C.W. Ma, MD, of The Chinese University of Hong Kong, and colleagues reported in the American Journal of Kidney Diseases. They also had significant 3.1-, 3.1-, and 5.5-fold increased risks of hospitalization for heart failure, respectively, and 1.6-, 2.0-, and 3.3-fold increased risks for all-cause mortality.

In addition, compared with patients who did not have DKD, those with decreased eGFR only had a nonsignificant increased risk for cardiovascular disease and death when baseline eGFR was above 30 mL/min/1.73 m², according to the investigators.

The study population had a mean age of 61.1 years. The mean duration of diabetes was 11.1 years. During 54,260 person-years of follow-up, 438 patients died and 298 hospitalizations for heart failure and 1161 episodes of CKD progression occurred.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Jin Q, Luk AO, Lau ES, et al. Nonalbuminuric diabetic kidney disease and risk of all-cause mortality and cardiovascular and kidney outcomes in type 2 diabetes: Findings from the Hong Kong Diabetes Biobank. Am J Kidney Dis. Published online January 6, 2022. doi:10.1053/.akd.2021.11.011

From the January 1, 2022 Issue of Renal and Urology News