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. 2015 Jul 31;10(1):131-6.
doi: 10.1177/1932296815596174.

Decreased eGFR as a Risk Factor for Heart Failure in 13 781 Individuals With Type 1 Diabetes

Daniel Vestberg  1 , Annika Rosengren  2 , Marita Olsson  3 , Soffia Gudbjörnsdottir  4 , Börje Haraldsson  2 , Ann-Marie Svensson  5 , Marcus Lind  6
Affiliations

Decreased eGFR as a Risk Factor for Heart Failure in 13 781 Individuals With Type 1 Diabetes

Daniel Vestberg et al. J Diabetes Sci Technol. .

Abstract

Background: Impaired renal function is a well-known risk factor of cardiovascular disease, but its relation to heart failure in individuals with type 1 diabetes has been sparsely studied. The aim of our study was to quantify the risk increase for development of heart failure with decreasing kidney function in individuals with type 1 diabetes.

Methods: Three equations were used to calculate eGFR (estimated glomerular filtration rate) for individuals with T1D and no known heart failure in the Swedish National Diabetes Registry. Proportional hazards regression models were constructed to evaluate the association between eGFR and hospitalization for heart failure (HF).

Results: Among 13 781 individuals (mean age 41.1 [SD 13.3] years at baseline), 330 (2.4%) were hospitalized for HF over median follow-up of 7.0 years. Renal function was normal (eGFR > 90 mL/min/1.73 m(2)) in 67% of individuals according to the Cockcroft-Gault formula, compared to 51% and 41% according to the Chronic Kidney Disease Epidemiology (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) formulas. For eGFR 45-60 ml/min/1.73 m(2), hazard ratios (HRs) for hospitalization (reference >90 mL/min/1.73 m(2)) were 3.18 (95% CI 2.17, 4.65), 2.12 (1.16, 3.08), and 2.44 (1.69, 3.55) using the Cockcroft-Gault, MDRD, and CKD-EPI formulas. With eGFR <30 ml/min/1.73 m(2) there was a HR of 3.78 (2.15, 5.91), 3.44 (2.14, 5.51), and 3.51 (2.21, 5.51) compared to normal kidney function (>90 mL/min/1.73 m(2)).

Conclusions: In individuals with T1D, risk of hospitalization for heart failure was over 2 times greater at eGFR 45-60 ml/min/1.73 m(2) and more than 3 times greater at eGFR <30 ml/min/1.73 m(2) when compared to normal eGFR.

Keywords: epidemiology; heart failure; kidney function; type 1 diabetes.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Parén P, Schaufenberger M, Björck L, Lappas G, Fu M, Rosengren A. Trends in prevalence from 1990 to 2007 of patients hospitalized with heart failure in Sweden. Eur J Heart Fail. 2014;16(7):737-742. - PubMed
    1. Lind M, Bounias I, Olsson M, Gudbjornsdottir S, Svensson AM, Rosengren A. Glycaemic control and incidence of heart failure in 20,985 patients with type 1 diabetes: an observational study. Lancet. 2011;378:140-146. - PubMed
    1. Barasa A, Schaufelberger M, Lappas G, Swedberg K, Dellborg M, Rosengren A. Heart failure in young adults: 20-year trends in hospitalization, aetiology, and case fatality in Sweden. Eur Heart J. 2014:35(1): 25-32. - PMC - PubMed
    1. Drury PL, Ting R, Zannino D, et al. Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. Diabetologia. 2011:54:32-43. - PubMed
    1. So WY, Kong AP, Ma RC, et al. Glomerular filtration rate, cardiorenal end points, and all-cause mortality in type 2 diabetic patients. Diabetes Care. 2006;29(9):2046-2052. - PubMed

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