| High cardiovascular risk in patients with Type 2 diabetic nephropathy: the predictive role of albuminuria and glomerular filtration rate. The NID-2 Prospective Cohort Study. | |
| | |
MedLine Citation:
|
PMID: 22090446 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: In Type 2 diabetic patients, clinical diagnosis of diabetic nephropathy (DN) is generally based on the concomitant presence of abnormal albuminuria and severe retinopathy. In this high-risk population, cardiovascular (CV) outcome has never been evaluated.METHODS: A cohort of 742 Type 2 diabetic patients with DN from 17 national centres was selected by the presence of persistent albuminuria ≥30 mg/day and severe diabetic retinopathy and was followed prospectively. Time to CV event (CV death, non-fatal myocardial infarction, non-fatal stroke, revascularization, major amputation) was the primary composite end point and it was analysed by multivariable Cox's proportional hazards model. The interaction between albuminuria and glomerular filtration rate (GFR) was specifically investigated.RESULTS: Median follow-up was 4.6 years. Overall 242 events (26% of which fatal) were observed in 202 patients. The proportion of CV events increased from 19 to 40% as GFR declined from the highest (≥90 mL/min/1.73m(2)) to the lowest (<45 mL/min/1.73m(2)) category and was equal to 25 and 33% in microalbuminuria and macroalbuminuria, respectively. In multivariable analysis, the interaction between albuminuria and GFR was statistically significant (P = 0.012). Albuminuria, indeed, had a remarkable prognostic effect in subjects with high GFR that virtually disappeared as GFR became <30 mL/min/1.73m(2). Age, smoking habit, previous occurrence of myocardial infarction or stroke and proliferative retinopathy were all found to have a statistically significant prognostic effect on CV outcome.CONCLUSIONS: A clinically based diagnosis of DN in Type 2 diabetes allows the identification of subjects with high CV risk. Albuminuria has a relevant prognostic effect on CV morbidity and mortality; its effect is especially pronounced when GFR is normal or near normal. |
| | |
Authors:
|
Ferdinando C Sasso; Paolo Chiodini; Ornella Carbonara; Luca De Nicola; Giuseppe Conte; Teresa Salvatore; Rodolfo Nasti; Raffaele Marfella; Ciro Gallo; Simona Signoriello; Roberto Torella; Roberto Minutolo; |
Related Documents
:
|
17445536 - Serum leptin and adiponectin are positively associated with bone mineral density at the... 21880226 - Evaluation of a novel continuous glucose measurement device in patients with diabetes m... 15959876 - A diabetes-like environment increases malformation rate and diminishes prostaglandin e(... 21631956 - Coffee and tea consumption in relation to inflammation and basal glucose metabolism in ... 15741056 - In vivo glucose monitoring: the clinical reality and the promise. 6765536 - Plasma insulin and c-peptide after subcutaneous and intravenous administration of human... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-11-16 |
Journal Detail:
|
Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: - ISSN: 1460-2385 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
|
Created Date: 2011-11-17 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
1Department of Internal and Experimental Medicine, Second University of Naples, Naples, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Identification and functional characterization of cDNAs coding for hydroxybenzoate/hydroxycinnamate ...
Next Document: A Vero Cell-Derived Whole-Virus H5N1 Vaccine Effectively Induces Neuraminidase-Inhibiting Antibodies...