Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes

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dc.contributor.author Ninomiya, T en
dc.contributor.author Perkovic, V en
dc.contributor.author De Galan, BE en
dc.contributor.author Zoungas, S en
dc.contributor.author Pillai, Avineshwaran en
dc.contributor.author Jardine, M en
dc.contributor.author Patel, A en
dc.contributor.author Cass, A en
dc.contributor.author Neal, B en
dc.contributor.author Poulter, N en
dc.contributor.author Mogensen, C en
dc.contributor.author Cooper, M en
dc.contributor.author Marre, M en
dc.contributor.author Williams, B en
dc.contributor.author Hamet, P en
dc.contributor.author Mancia, G en
dc.contributor.author Woodward, M en
dc.contributor.author MacMahon, S en
dc.contributor.author Chalmers, J en
dc.date.accessioned 2012-06-04T23:35:40Z en
dc.date.issued 2009 en
dc.identifier.citation Journal of the American Society of Nephrology 20:1813-1821 Article number 8 2009 en
dc.identifier.issn 1046-6673 en
dc.identifier.uri http://hdl.handle.net/2292/18876 en
dc.description.abstract There are limited data regarding whether albuminuria and reduced estimated GFR (eGFR) are separate and independent risk factors for cardiovascular and renal events among individuals with type 2 diabetes. The Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE) study examined the effects of routine BP lowering on adverse outcomes in type 2 diabetes. We investigated the effects of urinary albumin-to-creatinine ratio (UACR) and eGFR on the risk for cardiovascular and renal events in 10,640 patients with available data. During an average 4.3-yr follow-up, 938 (8.8%) patients experienced a cardiovascular event and 107 (1.0%) experienced a renal event. The multivariable-adjusted hazard ratio for cardiovascular events was 2.48 (95% confidence interval 1.74 to 3.52) for every 10-fold increase in baseline UACR and 2.20 (95% confidence interval 1.09 to 4.43) for every halving of baseline eGFR, after adjustment for regression dilution. There was no evidence of interaction between the effects of higher UACR and lower eGFR. Patients with both UACR 300 mg/g and eGFR 60 ml/min per 1.73 m2 at baseline had a 3.2-fold higher risk for cardiovascular events and a 22.2-fold higher risk for renal events, compared with patients with neither of these risk factors. In conclusion, high albuminuria and low eGFR are independent risk factors for cardiovascular and renal events among patients with type 2 diabetes. en
dc.publisher American Society of Nephrology en
dc.relation.ispartofseries Journal of the American Society of Nephrology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes en
dc.type Journal Article en
dc.identifier.doi 10.1681/ASN.2008121270 en
pubs.begin-page 1813 en
pubs.volume 20 en
dc.rights.holder Copyright: American Society of Nephrology en
dc.identifier.pmid 19443635 en
pubs.end-page 1821 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 295833 en
pubs.org-id Science en
pubs.org-id Statistics en
pubs.number 8 en
pubs.record-created-at-source-date 2012-02-16 en
pubs.dimensions-id 19443635 en


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