Diabetologia: Renal outcome and all-cause mortality in type 2 diabetic patients with non-proteinuria renal insufficiency

It is not clear whether diabetic patients with non-albuminuria renal insufficiency have a higher risk of decreased renal function and death than diabetic patients with preserved renal function without albuminuria
.
In addition, there is little information on the incidence of albuminuria in patients with this unique phenotype

This study aims to clarify the risk of renal outcome and all-cause mortality in diabetic patients with non-albuminuria renal insufficiency
.

This is a retrospective cohort study involving 8320 adult patients with type 2 diabetes.
Based on proteinuria (urinary protein ≥30 mg/g or <30 mg/g) and renal insufficiency (eGFR≥60 ml) at baseline /min·1.
73 m2 or <60 ml/min·1.
73 m2) state divided the test patients into four groups
.
The primary composite renal endpoint is a 50% reduction in eGFR from baseline or the initiation of renal replacement therapy

Cumulative incidence of primary renal endpoint

Compared with diabetic patients with preserved renal function without albuminuria, diabetic patients with non-albuminuria renal insufficiency have a higher risk of the primary renal endpoint (hazard ratio [HR] 4.
1; 95% CI 2.
5- 6.
7; p<0.
001), steep percentage change in eGFR slope (-1.
96%/year vs -1.
36%/year, p<0.
001), incidence of proteinuria (HR 2.
1; 1.
7-2.
6; p<0.
001), and all-cause Mortality rate (HR 1.
5; 1.
2-2.
0; p=0.
003)
.

Cumulative incidence of all-cause mortality

In a sensitivity analysis that considers the incidence of proteinuria as a competitive risk, compared with patients with non-albuminuria renal insufficiency, the primary renal endpoint of patients with non-albuminuria renal insufficiency (HR 2.

Original source:

Yamamoto, Y.