title: The Presence and Consequence of Nonalbuminuric Chronic Kidney Disease in Patients With Type 1 Diabetes.
abstract: OBJECTIVE
  This study investigated the prevalence of nonalbuminuric chronic kidney disease in type 1 diabetes to assess whether it increases the risk of cardiovascular and renal outcomes as well as all-cause mortality.
  
  
  METHODS
  This was an observational follow-up of 3,809 patients with type 1 diabetes from the Finnish Diabetic Nephropathy Study. All patients were Caucasians and thoroughly examined at baseline. Their mean age was 37.6 ± 11.8 years and duration of diabetes 21.2 ± 12.1 years. Follow-up data on cardiovascular and renal outcomes and mortality were retrieved from registers. During 13 years of median follow-up, 378 developed end-stage renal disease, 415 suffered an incident cardiovascular event, and 406 died.
  
  
  RESULTS
  At baseline, 78 (2.0%) had nonalbuminuric chronic kidney disease. This was associated with older age, female sex, history of retinal laser treatment, cardiovascular events, and the number of antihypertensive drugs in use, but not with blood pressure levels or specific antihypertensive agents. Nonalbuminuric chronic kidney disease did not increase the risk of albuminuria (hazard ratio [HR] 2.0 [95% CI 0.9-4.4]) or end-stage renal disease (HR 6.4 [0.8-53.0]) but did increase the risk of cardiovascular events (HR 2.0 [1.4-3.5]) and all-cause mortality (HR 2.4 [1.4-3.9]). The highest risk of cardiovascular and renal end points was observed in the patients with albuminuria.
  
  
  CONCLUSIONS
  Nonalbuminuric chronic kidney disease is not a frequent finding in patients with type 1 diabetes, but when present, it is associated with an increased risk of cardiovascular morbidity and all-cause mortality but not with renal outcomes.
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Lena M
authors: LM
authors: Thorn
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Daniel
authors: D
authors: Gordin
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Valma
authors: V
authors: Harjutsalo
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Stefanie
authors: S
authors: Hägg
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Robert
authors: R
authors: Masar
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Markku
authors: M
authors: Saraheimo
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Nina
authors: N
authors: Tolonen
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Johan
authors: J
authors: Wadén
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia per-henrik.groop@helsinki.fi.
authors: Per-Henrik
authors: PH
authors: Groop
authors: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
authors: Carol M
authors: CM
authors: Forsblom
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D003928:Diabetic Nephropathies / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors