Regression of albuminuria and its association with incident cardiovascular outcomes and mortality in type 1 diabetes: the FinnDiane Study

Show full item record



Permalink

http://hdl.handle.net/10138/300778

Citation

The FinnDiane Study Group , Jansson , F J , Forsblom , C , Harjutsalo , V , Thorn , L M , Wadén , J , Elonen , N , Ahola , A J , Saraheimo , M & Groop , P-H 2018 , ' Regression of albuminuria and its association with incident cardiovascular outcomes and mortality in type 1 diabetes: the FinnDiane Study ' , Diabetologia , vol. 61 , no. 5 , pp. 1203-1211 . https://doi.org/10.1007/s00125-018-4564-8

Title: Regression of albuminuria and its association with incident cardiovascular outcomes and mortality in type 1 diabetes: the FinnDiane Study
Author: The FinnDiane Study Group; Jansson, Fanny J.; Forsblom, Carol; Harjutsalo, Valma; Thorn, Lena M.; Wadén, Johan; Elonen, Nina; Ahola, Aila J.; Saraheimo, Markku; Groop, Per-Henrik
Contributor: University of Helsinki, HUS Abdominal Center
University of Helsinki, Research Programs Unit
University of Helsinki, Research Programs Unit
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
University of Helsinki, Nefrologian yksikkö
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
Date: 2018-05
Language: eng
Number of pages: 9
Belongs to series: Diabetologia
ISSN: 0012-186X
URI: http://hdl.handle.net/10138/300778
Abstract: Aims/hypothesis Our aim was to assess regression of albuminuria and its clinical consequences in type 1 diabetes. Methods The analysis included 3642 participants from the Finnish Diabetic Nephropathy (FinnDiane) Study with a 24 h urine sample and a history of albuminuria available at baseline. A total of 2729 individuals had normal AER, 438 a history of microalbuminuria and 475 a history of macroalbuminuria. Regression was defined as a change from a higher category of albuminuria pre-baseline to a lower category in two out of the three most recent urine samples at baseline. The impact of regression on cardiovascular events (myocardial infarction, stroke, coronary procedure) and mortality was analysed over a follow-up of 14.0 years (interquartile range 11.9-15.9). Results In total, 102 (23.3%) individuals with prior microalbuminuria and 111 (23.4%) with prior macroalbuminuria had regressed at baseline. For individuals with normal AER as a reference, the age-adjusted HRs (95% CI) for cardiovascular events were 1.42 (0.75, 2.68) in individuals with regression from microalbuminuria, 2.62 (1.95, 3.54) in individuals with sustained microalbuminuria, 3.15 (2.02, 4.92) in individuals with regression from macroalbuminuria and 5.49 (4.31, 7.00) in individuals with sustained macroalbuminuria. Furthermore, for all-cause and cardiovascular mortality rates, HRs in regressed individuals were comparable with those with sustained renal status at the achieved level (i.e. those who did not regress but remained at the most advanced level of albuminuria noted pre-baseline). Conclusions/interpretation Progression of diabetic nephropathy confers an increased risk for cardiovascular disease and premature death. Notably, regression reduces the risk to the same level as for those who did not progress.
Subject: Albumin excretion rate
Albuminuria
BLOOD-PRESSURE
Cardiovascular disease
DISEASE
Diabetic nephropathy
EXCRETION
FOLLOW-UP
MACROALBUMINURIA
MICROALBUMINURIA
Mortality
NEPHROPATHY
REMISSION
RENAL OUTCOMES
RISK
Type 1 diabetes
3121 General medicine, internal medicine and other clinical medicine
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
10.1007_s00125_018_4564_8.pdf 890.0Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record