Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Diabetes & Long-Term Kidney Disease

Diabetes Care; ePub 2018 Jun 1; Warren, et al

Diabetes is a significant risk factor for kidney function decline, as those with diagnosed diabetes likely to decline nearly twice as rapidly as those without diabetes, a recent study found. Researchers classified 15,517 participants in the community-based Atherosclerosis Risk in Communities (ARIC) study by diabetes status at baseline (1987-1989; no diabetes, undiagnosed diabetes, and diagnosed diabetes). They then used linear mixed models with random intercepts and slopes to quantify estimated glomerular filtration rate (eGFR) trajectories at 4 visits over 26 years. Among the findings:

  • Adjusted mean eGFR decline over the full study period among those without diabetes was ‒1.4 mL/min/1.73 m2/year; with undiagnosed diabetes was ‒1.8 mL/min/1.73 m2/year; and with diagnosed diabetes was ‒2.5 mL/min/1.73 m2/year.
  • Among those with diagnosed diabetes, steeper declines were seen in those with modifiable risk factors, including hypertension and glycemic control.
  • Among those with diagnosed diabetes, risk factors for steeper eGRF decline also included African American race and APOL1 high-risk genotype.

Citation:

Warren B, Rebholz CM, Sang Y, et al. Diabetes and trajectories of estimated glomerular filtration rate: A prospective cohort analysis of the Atherosclerosis Risk in Communities study. [Published online ahead of print June 1, 2018]. Diabetes Care. doi:10.2337/dc18-0277.

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