Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function.

Autor:	Seo DH; Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea., Kim SH; Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea., Song JH; Department of Nephrology and Hypertension, Inha University School of Medicine, Incheon, Korea., Hong S; Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea., Suh YJ; Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Korea., Ahn SH; Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea., Woo JT; Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea., Baik SH; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Park Y; Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, IL, USA., Lee KW; Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea., Kim YS; Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea., Nam M; Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea. namms@inha.ac.kr.
Jazyk:	angličtina
Zdroj:	Diabetes & metabolism journal [Diabetes Metab J] 2019 Dec; Vol. 43 (6), pp. 840-853. Date of Electronic Publication: 2019 Mar 12.
DOI:	10.4093/dmj.2018.0186
Abstrakt:	Background: Recent evidences indicate that early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease. We have investigated the association between carotid atherosclerosis and rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function. Methods: In a prospective, multicenter cohort, a total of 967 patients with type 2 diabetes mellitus and preserved renal function were followed for 6 years with serial estimated glomerular filtration rate (eGFR) measurements. Common carotid intima-media thickness (CIMT) and presence of carotid plaque were assessed at baseline. Rapid renal function decline was defined as an eGFR decline >3.3% per year. Results: Over a median follow-up of 6 years, 158 participants (16.3%) developed rapid renal function decline. While there was no difference in CIMT, the presence of carotid plaque in rapid decliners was significantly higher than in non-decliners (23.2% vs. 12.2%, P <0.001). In multivariable logistic regression analysis, presence of carotid plaque was an independent predictor of rapid renal function decline (odds ratio, 2.33; 95% confidence interval, 1.48 to 3.68; P <0.0001) after adjustment for established risk factors. The model including the carotid plaque had better performance for discrimination of rapid renal function decline than the model without carotid plaque (area under the receiver operating characteristic curve 0.772 vs. 0.744, P =0.016). Conclusion: Close monitoring of renal function and early intensive management may be beneficial in patients with type 2 diabetes mellitus and carotid plaques. Competing Interests: No potential conflict of interest relevant to this article was reported. (Copyright © 2019 Korean Diabetes Association.)
Databáze:	MEDLINE
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