title: Association of kidney disease measures with risk of renal function worsening in patients with hypertension and type 2 diabetes.
abstract: OBJECTIVE
  To assess the role of kidney disease measures on the development of chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) and hypertension (HT).
  
  
  METHODS
  Clinical records from a total of 17,160 patients with T2D and HT, a baseline estimated glomerular filtration rate (eGFR) values ≥60mL/min/1.73m2, evaluation for albuminuria and regular visits during a four-year follow-up were retrieved and analyzed. The incidence of eGFR <60mL/min/1.73m2and/or a reduction >30% from baseline was evaluated.
  
  
  RESULTS
  At baseline 23% of patients (n=3873) had albuminuria. Over the 4-year follow-up 20% (n=3480) developed a renal endpoint 28% (n=1074) of those with albuminuria and 17% (n=2406) of those without albuminuria. The presence of baseline albuminuria entailed a 1.8 independent, greater risk of reaching stage 3 CKD. Patients with normal albuminuria showed a 1.54 (p<0.001) greater risk for each 5mL reduction (below 90mL/min) in baseline GFR.
  
  
  CONCLUSIONS
  In T2D patients with HT, eGFR reduction and albuminuria are independently associated with a greater risk of developing stage 3 CKD. While baseline albuminuria entails a greater renal risk, due to a larger occurrence of the non-albuminuric phenotype, renal function worsening is more likely to be observed in patients without albuminuria.
authors.affiliation: Università degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy. Electronic address: francesca.viazzi@unige.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.affiliation: Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Piscitelli
authors.affiliation: Diabetes and Metabolism Unit ASL Turin 5 Chieri (TO), Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Giorda
authors.affiliation: Institut d'Investigacions Biomèdiques August Pii Sunyer (IDIBAPS) and Centro de Investigación Biomédicaen Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain; Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni, Milano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
authors.affiliation: Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni, Milano, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Genovese
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Giuseppina T
authors.initials: GT
authors.lastname: Russo
authors.affiliation: Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Fioretto
authors.affiliation: Associazione Medici Diabetologi, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Guida
authors.affiliation: Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Cosmo
authors.affiliation: Università degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontremoli
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000209:etiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Albuminuria; Chronic kidney disease; Glomerular filtration rate; Risk factors; Type 2 diabetes