Rapid kidney function decline and increased risk of heart failure in patients with type 2 diabetes: findings from the ACCORD cohort

Autor: Carlos Roberto Bueno Junior, Arjola Bano, Yaling Tang, Xiuqin Sun, Alex Abate, Elizabeth Hall, Joanna Mitri, Mario Luca Morieri, Hetal Shah, Alessandro Doria
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cardiovascular Diabetology, Vol 22, Iss 1, Pp 1-12 (2023)
Druh dokumentu: article
ISSN: 1475-2840
DOI: 10.1186/s12933-023-01869-6
Popis: Abstract Background Impaired kidney function and albuminuria are associated with increased risk of heart failure (HF) in patients with type 2 diabetes (T2D). We investigated whether rapid kidney function decline over time is an additional determinant of increased HF risk in patients with T2D, independent of baseline kidney function, albuminuria, and other HF predictors. Methods Included in the study were 7,539 participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study with baseline urinary albumin-to-creatinine ratio (UACR) data, who had completed 4 years of follow-up and had ≥ 3 eGFR measurements during that period (median eGFR/year = 1.9, IQR 1.7–3.2). The association between rapid kidney function decline (eGFR loss ≥ 5 ml/min/1.73 m2/year) and odds of HF hospitalization or HF death during the first 4 years of follow-up was estimated by logistic regression. The improvement in risk discrimination provided by adding rapid kidney function decline to other HF risk factors was evaluated as the increment in the area under the Receiving Operating Characteristics curve (ROC AUC) and integrated discrimination improvement (IDI). Results Over 4 years of follow-up, 1,573 participants (20.9%) experienced rapid kidney function decline and 255 (3.4%) experienced a HF event. Rapid kidney function decline was associated with a ~ 3.2-fold increase in HF odds (3.23, 95% CI, 2.51–4.16, p
Databáze: Directory of Open Access Journals
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