- In patients with type 2 diabetes (T2D), albuminuria is both a risk marker for renal and cardiovascular disease and an independent therapeutic target.
Why this matters
- Albuminuria is associated with adverse renal and cardiovascular outcomes in patients with T2D.
- Data analyzed for 11,074 new insulin users with T2D and baseline urinary albumin-to-creatinine ratio (ACR) ≥300 mg/g (albuminuria) from general UK practices, 2007-2014.
- Of those, albuminuria regressed (ACR
- Funding: Medical Research Council, Arthritis Research UK.
- 5-year survival was:
- 95% for patients with regression, vs
- 91% with persistent albuminuria;
- 61 vs 621 deaths, respectively (P<.001>
- Mortality rate adjusted for change in HbA1c and mean arterial pressure was 31% lower in regression vs persistent albuminuria groups:
- adjusted [a]HR, 0.69 (P=.008).
- Risk for cardiovascular events (nonfatal myocardial infarction, stroke) was 27% lower in regression group:
- aHR, 0.73 (P=.041).
- Risk for composite major adverse cardiovascular events (all-cause mortality or nonfatal myocardial infarction or stroke) was 27% lower in regression group:
- aHR, 0.737 (P=.002).
- Possible residual confounding.
- Effect of competing hazards may bias risk estimates.
- Changes in medications after baseline not evaluated.