Non-Albuminuric CKD Increases Risk for Cardiovascular Events And Mortality Risk in Type 1 Diabetes Patients

Non-Albuminuric CKD Increases Risk for Cardiovascular Events And Mortality Risk in Type 1 Diabetes Patients

Results from a recent study published in the journal Diabetes Care, showed that adults with type 1 diabetes and non-albuminuric chronic kidney disease are at increased risk for both cardiovascular events and all-cause death, but no increased risk for albuminuria or end-stage renal disease.

Most diabetic patients with impaired renal function have a urinary albumin excretion rate in the normal range. In these patients, the etiology of renal impairment and whether it is unique to diabetics is unclear.

To investigate the prevalence of nonalbuminuric chronic kidney disease in patients with a diagnosis of type 1 diabetes, and to examine if it increases the risk of cardiovascular and renal outcomes and all-cause mortality, Dr. Per-Henrik Groop, from the Folkhälsan Institute of Genetics, Folkhälsan Research Center Helsinki in Finland and colleagues conducted an observational follow-up study of more than 3,800 Finnish patients with type 1 diabetes.

Patients were participating in the Finnish Diabetic Nephropathy Study. Using Finnish hospital discharge records and death records, the researchers obtained data on ESRD and CV events, including myocardial infarction, coronary revascularization, stroke or CV death.

The results revealed that at baseline, 78 patients had nonalbuminuric chronic kidney disease. Statistical analyses showed an association between nonalbuminuric chronic kidney disease and female sex, older age, cardiovascular events, history of retinal laser treatment, and the amount of antihypertensive drugs patients were using. However the results showed no association between nonalbuminuric chronic kidney disease and blood pressure levels or specific antihypertensive drugs.

Nonalbuminuric chronic kidney disease did not increase the risk of end-stage renal disease or of albuminuria. However, nonalbuminuric chronic kidney disease was found to increase the risk of cardiovascular events and all-cause.

The highest risk of cardiovascular and renal outcomes was seen in those patients with albuminuria.

“A novel finding was that non-albuminuric CKD increased the risk of [CV] morbidity and all-cause mortality to the same extent as albuminuric non-CKD, but did not increase the risk of renal outcomes in type 1 diabetes,” the researchers wrote in a recent news release. “The highest risk of the outcomes studied was observed in the patients with albuminuric CKD. Whether non-albuminuric CKD is true diabetic nephropathy or not, our study indicates that it is associated with a more favorable prognosis regarding renal disease progression but nonetheless increases the risk of [CV] outcomes and all-cause mortality in these patients,” they added.

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Daniela holds a PhD in Clinical Psychology from The University of Edinburgh, United Kingdom, a MSc in Health Psychology and a BSc in Clinical Psychology. Her work has been focused on vulnerability to psychopathology and early identification and intervention in psychosis.

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