Our analyses show that the cumulative incidence of severe albuminuria has decreased between 1970–79 and 1980–99; however, whether this decrease solely denotes a delay in albuminuria, or also a true prevention of albuminuria, needs to be investigated further. Nevertheless, diabetic kidney disease remains a significant complication of type 1 diabetes. Due to the robust association of diabetic kidney disease with premature mortality, novel therapies to improve prognosis are needed (The Lancet Diabetes & Endocrinology)
Diabetes News
Tag: albuminuria
Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study
This study identified multiple prediction models to predict albuminuria, diabetic kidney disease, chronic kidney disease, and end stage renal disease. In the external validation, discrimination and calibration for albuminuria, diabetic kidney disease, and chronic kidney disease varied considerably across prediction horizons and models (BMJ)
Progressive Decline in Estimated Glomerular Filtration Rate in Patients With Diabetes After Moderate Loss in Kidney Function—Even Without Albuminuria
Our results support a diabetes-dependent decline in kidney function without albuminuria following CKD3, with a subgroup showing a progressive decline. Furthermore, this group seems to be undertreated in terms of cardioprotective and renal-protective treatment and suggests that increased attention should be drawn to normoalbuminuric diabetic kidney disease (Diabetes Care)
Albuminuria Regression and All-Cause Mortality among Insulin-Treated Patients with Type 2 Diabetes: Analysis of a Large UK Primary Care Cohort
In patients with insulin-treated T2D and nephropathy in routine practice, a regression in albuminuria (e.g., via better BP or glycemic control) is associated with a significant reduction in all-cause mortality. Thus, albuminuria is not only simply a risk marker of renal and CV disease but also an independent target for therapy. Albuminuria reduction should be viewed as a goal for renal and CV protection (Nephrology)
The ratio of AGE to sRAGE independently associated with albuminuria in hypertensive patients
This study suggests that the ratio of AGE to sRAGE may be a surrogate biomarker for microvascular injury (BMC Endocrine Disorders)
Efficacy of a novel inhibitor of vascular adhesion protein-1 in reducing albuminuria in patients with diabetic kidney disease (ALBUM): a randomised, placebo-controlled, phase 2 trial
ASP8232 is effective in reducing albuminuria in patients with diabetic kidney disease and is safe and well tolerated. These findings warrant further research to ascertain the effect of ASP8232 on delaying progression of diabetic kidney disease (The Lancet Diabetes & Endocrinology)
Changes in Albuminuria and the Risk of Major Clinical Outcomes in Diabetes: Results From ADVANCE-ON
Changes in UACR predicted changes in the risk of major clinical outcomes and mortality in type 2 diabetes, supporting the prognostic utility of monitoring albuminuria change over time (Diabetes Care)
HbA1c variability in type 2 diabetes is associated with the occurrence of new-onset albuminuria within three years
HbA1c-CV improves 3-year prognostication of new-onset albuminuria. Together with mean HbA1c, baseline urine albumin and presence of hypertension, accurate 3-year new-onset albuminuria prognostication may be possible (Diabetes Research and Clinical Practice)
Effect of Saxagliptin on Renal Outcomes in the SAVOR-TIMI 53 Trial
Treatment with saxagliptin improved ACR, even in the normoalbuminuric range, without affecting eGFR. The beneficial effect of saxagliptin on albuminuria could not be explained by its effect on glycemic control (Diabetes Care)
Urinary albumin excretion with sitagliptin compared to sulfonylurea as add on to metformin in type 2 diabetes patients with albuminuria: a real-world evidence study
Our results suggest that both sitagliptin and SU reduce albuminuria as an add-on therapy to metformin, but that sitagliptin may provide greater reductions in albuminuria independent of glycemic control when compared to SU. Larger population studies are required to further explore this (Diabetes and Its Complications)
Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data
Creatinine-based eGFR and albuminuria should be taken into account for cardiovascular prediction, especially when these measures are already assessed for clinical purpose or if cardiovascular mortality and heart failure are outcomes of interest (The Lancet Diabetes & Endocrinology)
Estimated glomerular filtration rate progression in UK primary care patients with type 2 diabetes and diabetic kidney disease: a retrospective cohort study
Only a minority of diabetic patients with DKD had quantitative albuminuria assessments. The relatively low proportion of DKD patients with ACEi or ARB prescriptions suggests a gap between healthcare practice and available scientific evidence during the study period. Increased albuminuria and older age were the most consistent predictors of subsequent eGFR decline (International Journal of Clinical Practice)
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