Diverging Association of Reduced Glomerular Filtration Rate and Albuminuria With Coronary and Noncoronary Events in Patients With Type 2 Diabetes

• DOI: 10.2337/dc11-1380
• Publication Date: 2011-11-29T09:14:07Z
• Authors: Anna Solini; Giuseppe Penno; Enzo Bonora; Cecilia Fondelli; Emanuela Orsi; Maura Arosio; Roberto Trevisan; Monica Vedovato; Mauro Cignarelli; Francesco Andreozzi; Antonio Nicolucci; Giuseppe Pugliese
• Keywords: Albuminuria

Although a reduced estimated glomerular filtration rate (eGFR) was shown to be powerful independent predictor of cardiovascular disease (CVD), other studies suggested that it confers much lower risk than albuminuria alone, whereas the combination two abnormalities is associated with multiplicative risk. This study aimed at assessing association previous CVD events, either total or by vascular bed, eGFR and chronic kidney (CKD) phenotypes.This cross-sectional evaluated 15,773 patients type 2 diabetes from Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicenter Study in 19 outpatient clinics years 2007-2008. Albuminuria assessed immunonephelometry immunoturbidimetry. GFR simplified Modification Diet Disease Chronic Kidney Disease-Epidemiology Collaboration equation. CKD defined as an <60 mL/min/1.73 m(2) micro- macroalbuminuria. Major acute events were adjudicated based on hospital discharge records specialist visits.CVD increased linearly decline became significant for values <78 ≥10.5 mg/24 h, respectively. Beyond traditional factors, showed alone (odds ratio 1.20 [95% CI 1.08-1.33]), (1.52 [1.34-1.73]), both (1.90 [1.66-2.19]). However, coronary predominantly cerebrovascular peripheral stronger correlation albuminuric phenotypes.These data, although cross-sectional, show eGFR, irrespective albuminuria, CVD, particularly district.