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Abstract: SA-PO282

Development in eGFR Trajectories in People With Diabetic Nephropathy

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Poulsen, Christina Gjerlev, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Jesse, Kristin, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Carstensen, Bendix, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Frimodt-Moller, Marie, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Hansen, Tine, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Persson, Frederik, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Vistisen, Dorte, Steno Diabetes Center Copenhagen, Herlev, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Denmark
Background

Diabetic nephropathy (DN) is a frequent and serious complication to type 1 diabetes (T1D) and type 2 diabetes (T2D). The effect of advancing diabetes care over the past decades on progression in DN requires update. We analyzed the development over calendar time in eGFR trajectories from time of DN diagnosis.

Methods

Retrospective cohort study, with data collected from electronic health records from persons attending the outpatient clinic at Steno Diabetes Center Copenhagen, Denmark between 2001-2020. Inclusion criteria were: T1D/T2D and DN, defined as urine albumin to creatinine ratio > 300 mg/g or urine albumin excretion rate > 300 mg/24h in two occasions > 60 days apart. Individual eGFR trajectories were calculated separately for T1D and T2D, using mixed-effects models with fixed effects of age and interactions of splines of DN duration and date of diagnosis.

Results

The T1D cohort included 888 persons, 59.7% male and median (IQR) age at DN diagnosis was 50 (38-62) years. Figure 1A shows estimated trajectories for eGFR for a person with T1D diagnosed with DN at age 50 in 2000, 2005, 2010 or 2015. eGFR at time of DN diagnosis increased with 1.8 ml/min/1.73m2/year. Improvement in eGFR trajectories with calendar time was not evident, but with a tendency toward attenuating decline after 2010.
The T2D cohort included 1480 persons, 71.9% male and median (IQR) age at DN diagnosis was 65 (58-72) years. Figure 1B shows estimated trajectories for eGFR for a person with T2D diagnosed with DN at age 65 in 2000, 2005, 2010 or 2015. eGFR at time of DN diagnosis increased with 0.7 ml/min/1.73m2/year. Most pronounced increase was between 2000 and 2005. The eGFR trajectories for T2D were similar across calendar time.

Conclusion

Kidney function at time of DN diagnoses has increased over the past 20 years, most pronounced in T1D, where eGFR decline appears attenuating in most recent years. This may be explained by improved awareness and treatment.

Funding

  • Private Foundation Support