ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO462

Increasing Baseline Albuminuria Is Associated with a Continuously Increased Risk of Cardiovascular (CV) and Renal Outcomes in the LEADER Trial

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Mosenzon, Ofri, Hadassah Hebrew University Hospital, Jerusalem, Israel
  • Bain, Stephen, Institute of Life Science, Swansea University, Swansea, United Kingdom
  • Persson, Frederik, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Lambers Heerspink, Hiddo Jan, University Medical Center Groningen, Groningen, Netherlands
  • Mann, Johannes F., KfH Kidney Center, and Friedrich Alexander University of Erlangen, Munich, Germany
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Gentofte, Denmark
  • Idorn, Thomas, Novo Nordisk A/S, Soborg, Denmark
  • Rasmussen, Soren, Novo Nordisk A/S, Soborg, Denmark
  • Von Scholten, Bernt Johan, Novo Nordisk A/S, Soborg, Denmark
  • Raz, Itamar, Hadassah Hebrew University Hospital, Jerusalem, Israel

Group or Team Name

  • The LEADER Publication Committee on behalf of the LEADER Trial Investigators
Background

Albuminuria is a known risk factor for CV disease, but the lower limit from which it is a risk factor is not well defined.

Methods

We assessed CV and renal outcomes by increasing levels of baseline urinary albumin-to-creatinine ratio (UACR) in the LEADER trial. LEADER was a randomized, double-blind, placebo-controlled CV outcomes trial of liraglutide up to 1.8 mg/day vs placebo added to standard care for 3.5–5 years in 9340 patients with type 2 diabetes and high risk for CV disease. We analyzed the risk of major adverse CV events (MACE), expanded MACE, all-cause death, and adjudicated renal events (doubling of serum creatinine and estimated glomerular filtration rate ≤45 ml/min/1.73 m2; the need for continuous renal-replacement therapy; or death from renal disease) by baseline UACR irrespective of treatment group; UACR < lower limit of quantification (LLoQ) (G0; n=1598), 0 to <15 mg/g (G1; n=2905), 15 to <30 mg/g (G2; n=1196), 30 to <100 mg/g (G3; n=1609), 100 to <300 mg/g (G4; n=845), and ≥300 mg/g (G5; n=960).

Results

The risk of MACE, expanded MACE, all-cause death and renal events increased with increasing baseline UACR (Figure), statistically significant for all subgroups with UACR ≥30 mg/g compared to G0. Interestingly, in patients at the higher part of the normoalbuminuric range (G2), a trend towards increased risk for CV events and all-cause death was observed.

Conclusion

In LEADER, baseline UACR≥30 mg/g was associated with increased risk of death, and CV and renal events, emphasizing the importance of albuminuria as a modifiable risk factor.

Funding

  • Commercial Support