Abstract: SA-PO544
Poor Renal and Cardiovascular Outcomes in Patients with Biopsy-Proven Diabetic Nephropathy
Session Information
- Diabetic Kidney Disease: Pathology, Epidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Wang, Niansong, Department of Nephrology ,Shanghai Jiao Tong University Affiliated Sixth People's Hospital ,Shanghai ,China, Shanghai, China
- Fan, Ying, Department of Nephrology ,Shanghai Jiao Tong University Affiliated Sixth People's Hospital ,Shanghai ,China, Shanghai, China
- Wang, Yiyun, Department of Nephrology ,Shanghai Jiao Tong University Affiliated Sixth People's Hospital ,Shanghai ,China, Shanghai, China
- Zhou, Ting, Department of Nephrology ,Shanghai Jiao Tong University Affiliated Sixth People's Hospital ,Shanghai ,China, Shanghai, China
Background
Despite high level of mortality related to cardiovascular disease (CVD) in diabetic patients with renal injury, few studies have compared cardiovascular characteristics and outcomes between patients with diabetic nephropathy (DN) and non-diabetic renal disease(NDRD).
Methods
A total of 370 T2DM patients with renal biopsy were assigned to one of three groups (DN, NDRD, and NDRD with underlying DN). Echocardiography and Doppler ultrasound were performed to evaluate left ventricle hypertrophy(LVH) and peripheral atherosclerosis disease(PAD). Renal and cardiovascular survival rates were compared between the DN and NDRD groups by Kaplan-Meier analysis (medium follow-up, 29 months). Risk factors for renal and cardiovascular events were identified by Cox proportional hazards model.
Results
DN patients were more vulnerable to developing LVH than NDRD patients (37.3% vs 6.8%, P < 0.001). PAD was more severe in DN group, with thicker intima-medium and more atherosclerotic plaques (P < 0.001). Poorer renal (log Rank X2 = 22.089, P < 0.001) and cardiovascular (log Rank X2 = 9.346, P = 0.002) prognosis were seen in DN group. Low estimated glomerular filtration rate at baseline was associated with renal events (HR = 0.962 [0.942–0.983], P = 0.001), while elevated levels of glycosylated hemoglobin A1c (HR = 1.599 [1.256–2.635], P = 0.041) and postprandial blood glucose (HR = 1.321 [1.072–1.626], P = 0.009) were identified as risk factors for cardiovascular events.
Conclusion
Patients with DN had more severe CVD along with poorer renal and cardiovascular prognosis than those with NDRD.
Funding
- Government Support - Non-U.S.