TY - JOUR
T1 - Relative incidence of ESRD versus cardiovascular mortality in proteinuric type 2 diabetes and nephropathy
T2 - Results from the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) database
AU - Packham, David K.
AU - Alves, Tahira P.
AU - Dwyer, Jamie P.
AU - Atkins, Robert
AU - De Zeeuw, Dick
AU - Cooper, Mark
AU - Shahinfar, Shahnaz
AU - Lewis, Julia B.
AU - Lambers Heerspink, Hiddo J.
N1 - Funding Information:
Support: The RENAAL trial was sponsored by Merck & Company. Drs de Zeeuw and Cooper received financial support from Merck & Co for their participation in the steering committee of the RENAAL trial. Dr Shahinfar was an employee of Merck at the time of the conduct of the RENAAL trial. IDNT was sponsored by Bristol Myer Squibb Institute for Medical Research and Sanofi-Synthelabo. Dr Atkins received research grants from Bristol Myer Squibb .
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2012/1
Y1 - 2012/1
N2 - Previous studies have shown that patients with chronic kidney disease, including those with diabetic nephropathy, are more likely to die of cardiovascular disease than reach end-stage renal disease (ESRD). This analysis was conducted to determine whether ESRD is a more common outcome than cardiovascular death in patients with type 2 diabetic nephropathy, significant proteinuria, and decreased kidney function who were selected for participation in a clinical trial. Retrospective analysis of the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) database derived from 2 prospective randomized controlled clinical trials (IDNT [Irbesartan Diabetic Nephropathy Trial] and RENAAL [Reduction of Endpoints in NonInsulin-dependent Diabetes With the Angiotensin II Antagonist Losartan]). 3,228 adult patients with type 2 diabetic nephropathy from IDNT and RENAAL were combined to establish the DIAMETRIC database. This is the largest global source of clinical information for patients with type 2 diabetic nephropathy who have decreased kidney function and significant proteinuria. Angiotensin receptor blocker versus nonangiotensin receptor blocker therapy to slow the progression of type 2 diabetic nephropathy (in the prospective trials). Incidence rates of ESRD, cardiovascular death, and all-cause mortality. Mean follow-up was 2.8 years; 19.5% of patients developed ESRD, approximately 2.5 times the incidence of cardiovascular death and 1.5 times the incidence of all-cause mortality. ESRD was more common than cardiovascular death in all subgroups analyzed with the exception of participants with low levels of albuminuria (albumin excretion <1.0 g/g) and well-preserved levels of kidney function (estimated glomerular filtration rate >45 mL/min/1.73 m 2) at baseline. All participants were included in a prospective clinical trial. Patients with type 2 diabetic nephropathy, characterized by decreased kidney function and significant proteinuria, are more likely to reach ESRD than die during 3 years' mean follow-up. Given the rapidly increasing number of cases of type 2 diabetes worldwide, this has implications for predicting future renal replacement therapy requirements.
AB - Previous studies have shown that patients with chronic kidney disease, including those with diabetic nephropathy, are more likely to die of cardiovascular disease than reach end-stage renal disease (ESRD). This analysis was conducted to determine whether ESRD is a more common outcome than cardiovascular death in patients with type 2 diabetic nephropathy, significant proteinuria, and decreased kidney function who were selected for participation in a clinical trial. Retrospective analysis of the DIAMETRIC (Diabetes Mellitus Treatment for Renal Insufficiency Consortium) database derived from 2 prospective randomized controlled clinical trials (IDNT [Irbesartan Diabetic Nephropathy Trial] and RENAAL [Reduction of Endpoints in NonInsulin-dependent Diabetes With the Angiotensin II Antagonist Losartan]). 3,228 adult patients with type 2 diabetic nephropathy from IDNT and RENAAL were combined to establish the DIAMETRIC database. This is the largest global source of clinical information for patients with type 2 diabetic nephropathy who have decreased kidney function and significant proteinuria. Angiotensin receptor blocker versus nonangiotensin receptor blocker therapy to slow the progression of type 2 diabetic nephropathy (in the prospective trials). Incidence rates of ESRD, cardiovascular death, and all-cause mortality. Mean follow-up was 2.8 years; 19.5% of patients developed ESRD, approximately 2.5 times the incidence of cardiovascular death and 1.5 times the incidence of all-cause mortality. ESRD was more common than cardiovascular death in all subgroups analyzed with the exception of participants with low levels of albuminuria (albumin excretion <1.0 g/g) and well-preserved levels of kidney function (estimated glomerular filtration rate >45 mL/min/1.73 m 2) at baseline. All participants were included in a prospective clinical trial. Patients with type 2 diabetic nephropathy, characterized by decreased kidney function and significant proteinuria, are more likely to reach ESRD than die during 3 years' mean follow-up. Given the rapidly increasing number of cases of type 2 diabetes worldwide, this has implications for predicting future renal replacement therapy requirements.
KW - Diabetes Mellitus Treatment for Renal Insufficiency Consortium (DIAMETRIC)
KW - Type 2 diabetic nephropathy
KW - cardiovascular mortality
KW - end-stage renal disease
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U2 - 10.1053/j.ajkd.2011.09.017
DO - 10.1053/j.ajkd.2011.09.017
M3 - Article
C2 - 22051245
AN - SCOPUS:83655201254
VL - 59
SP - 75
EP - 83
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 1
ER -