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Abstract: PO0743

Independent Predictive Factors of Estimated GFR Decline in Type 2 Diabetes Patients with Preserved Kidney Function

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Hirano, Daishi, Tokyo Jikeikai Ika Daigaku, Minato-ku, Tokyo, Japan
  • Unoki-Kubota, Hiroyuki, Kokuritsu Kokusai Iryo Kenkyu Center Tonyobyo Joho Center, Shinjuku-ku, Tokyo, Japan
  • Imasawa, Toshiyuki, Department of Nephrology, National Hospital Organization Chibahigashi National Hospital,, Chiba, Chiba, Japan
  • Kajio, Hiroshi, Kokuritsu Kokusai Iryo Kenkyu Center Tonyobyo Joho Center, Shinjuku-ku, Tokyo, Japan
  • Yamashita, Shigeo, Tokyo Yamate Medical Center, Shinjuku-ku, Tokyo, Japan
  • Fukazawa, Yuka, JR Tokyo Sogo Byoin, Shibuya-ku, Tokyo, Japan
  • Kaburagi, Yasushi, Kokuritsu Kokusai Iryo Kenkyu Center Tonyobyo Joho Center, Shinjuku-ku, Tokyo, Japan
Background

We examined predictors of annual decline in estimated glomerular filtration (eGFR) in patients with type 2 diabetes and preserved kidney function.

Methods

In a prospective, observational cohort study, 392 Japanese patients with type 2 diabetes and baseline eGFR ≥ 60 ml/min/1.73m2 were followed over one year (mean period 5.5 years; IQR 3.9-7.3). Linear regression was used to estimate participants’ annual decline rate in eGFR over time. We defined subjects with an annual eGFR decline ≥ 5% per year as rapid progression and the eGFR decline < 5% as slow progression. In addition, time-averaged values of each laboratory data were calculated and used for sensitivity analysis.

Results

The study population had a median age of 59.0 years (IQR, 53.0–64.0) and 75% were male. The median duration of diabetes was 15.9 years (IQR, 11.2–20.4). During the follow-up period, 46 (11.7%) patients had a rapid decline in eGFR (median decline -6.51%; IQR, -8.59 – -5.60). Compared to patients with a slow decline in eGFR (N = 346), those with a rapid decline in eGFR had significantly higher HbA1c levels and lower HDL-cholesterol (HDL-c) levels at baseline. Multivariable logistic regression models revealed that lower baseline hemoglobin and HDL-c levels were independent predictors of annual decline in eGFR (OR, 0.69, 95% CI, 0.53–0.89, P = 0.005; OR, 0.97, 95% CI 0.94–0.99, P = 0.007, respectively). Furthermore, time-averaged hemoglobin and HDL-c levels were also independent predictors of annual decline in eGFR (OR, 0.62, 95% CI, 0.46–0.82, P = 001; OR, 0.97, 95% CI 0.94–0.99, P = 0.007, respectively).

Conclusion

Our findings highlight the important effect of lower hemoglobin and HDL-c levels as independent predictors of rapid decline in eGFR in patients with type 2 diabetes and preserved kidney function.