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.
PY - 2012/1/1
Y1 - 2012/1/1
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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UR - http://www.scopus.com/inward/citedby.url?scp=83655201254&partnerID=8YFLogxK
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 -