Abstract: FR-PO0343
Association of Urine Albumin and Creatinine Values Within the Normal Range with Future Rate of Kidney Function Loss in Adults Living with Type 2 Diabetes
Session Information
- Diabetic Kidney Disease: Progression, Predictive Tools, Therapeutics, and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Ali, Rawya B M, Galway University Hospitals, Galway, County Galway, Ireland
- Casey, Caoimhe Marie, Galway University Hospitals, Galway, County Galway, Ireland
- Griffin, Tomas P., Galway University Hospitals, Galway, County Galway, Ireland
- Griffin, Matthew D., Galway University Hospitals, Galway, County Galway, Ireland
Group or Team Name
- Royal College of Physicians of Ireland.
Background
Diabetes mellitus (DM) is a leading cause of chronic kidney disease (CKD). Albuminuria above normal range is a strong predictor for developing CKD. There is less evidence regarding the prognosis and optimal treatment of individuals with DM who have normal uACR. The aims of this study were to: 1. Determine the rate of decline of kidney function in adults with type 2(T2)DM, preserved kidney function and normal uACR. 2. Determine whether variation within the accepted normal range for uACR predicts their subsequent rate of eGFR decline.
Methods
A retrospective study of 4,464 adults attending the University Hospital Galway Diabetes Center was performed. Inclusion criteria: ≥18 years, diagnosis of T2DM, eGFR ≥60ml/min/1.73 m2 and uACR ≤3.0mg/mmol at an index outpatient visit (T0) between 2012 and 2016. Baseline and serial data were collected from electronic records up to December 2023. Primary outcome was rate of eGFR decline from T0 to last follow-up expressed as absolute or percent change/year. Statistical analyses, performed using IBM SPSS v28.0.0.0(190).
Results
In total, 1,834 individuals met inclusion criteria. This cohort was divided into tertiles based on uACR value at the index visit [high-normal (n=613, uACR range 1.24-3.0 mg/mmol), mid-normal (n=612, uACR range 0.68-1.23 mg/mmol) and low-normal (n=609, 0.15-0.67 mg/mmol)]. Absolute rates of eGFR decline (mean±SD ml/min/year) for the three tertiles were significantly different: High-normal -1.43±2.90; Mid-normal -1.25±2.66; Low-normal -0.85±2.55 (p=0.002). Percent eGFR decline (%change/year) for the three tertiles was also significantly different: High-normal -2.2±4.8; Mid-normal -2.0±4.6; Low-normal -1.3±2.9 (p=0.005). Baseline eGFR and BMI were similar across the tertiles, but age, DM duration, HbA1c and SBP were sequentially higher in comparisons of High-normal, Mid-normal and Low-normal tertiles.
Conclusion
In adults with T2DM, eGFR≥60 and normal uACR, higher numerical value for uACR associated with: (a) Greater subsequent rate of eGFR decline. (b) Other less favourable clinical and laboratory indices of risk. Thus, the numerical value for uACR, even within normal range, may guide the optimisation of reno-protective therapies in T2DM.