title: Association between copeptin and declining glomerular filtration rate in people with newly diagnosed diabetes. The Skaraborg Diabetes Register.
abstract: OBJECTIVE
  Copeptin has shown association with development of chronic kidney disease (CKD) in people with diabetes. Early detection of individuals having the highest risk could help avoid this complication. Therefore we decided to study copeptin concentrations and estimated glomerular filtration rate (eGFR) retrospectively in people with newly diagnosed diabetes.
  
  
  METHODS
  People with newly diagnosed type 2 diabetes in 1996-1998 from Skaraborg Diabetes Register (SDR) were reinvestigated in 2008-2010. Copeptin concentration at the time of diagnosis was determined. Creatinine and cystatin C were used for determination of eGFR at baseline and at reinvestigation (n=161). Data on cardiovascular complications were extracted from national registers. Analyzes were done with logistic regression.
  
  
  RESULTS
  From baseline to follow up eGFR decreased with 33ml. Twenty-nine individuals (18.1%) developed CKD stage 3. There was a significant association between elevated copeptin concentrations and development of CKD stage 3 (OR=1.78, 95% CI=1.01-3.16). When adjusting for GFR at baseline the association between copeptin and GFR decline was borderline significant (OR=1.79, 95% CI=0.99-3.25, p=0.055).
  
  
  CONCLUSIONS
  Determination of copeptin may early identify people with diabetes and high risk for CKD. To prevent complications for these individuals aggressive treatment should be discussed.
authors: Center for Primary Health Care Research, Department of Clinical Sciences, Jan Waldenströms gata 35, 205 02 Malmö, Lund University, Sweden; Husensjö Health Care Centre, Skaragatan 102, 25363 Helsingborg, Sweden. Electronic address: miriam.pikkemaat@med.lu.se.
authors: M
authors: M
authors: Pikkemaat
authors: Department of Medicine, Malmö University Hospital, Södra Förstadsgatan 101, 21428 Malmö, Lund University, Sweden.
authors: O
authors: O
authors: Melander
authors: R&D Centre, Skaraborg Primary Care, Långgatan 18, 541 30 Skövde, Sweden.
authors: K
authors: K
authors: Bengtsson Boström
mesh_terms: D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; D011933:Reagent Kits, Diagnostic; C048197:copeptins
keywords: Chronic kidney disease; Complications; Copeptin; Diabetes; Glomerular filtration rate