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. 2021 Dec;43(1):477-487.
doi: 10.1080/0886022X.2021.1893186.

Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus

Honghong Ren  1 , Lijun Zhao  1 , Yutong Zou  1 , Yiting Wang  1 , Junlin Zhang  1 , Yucheng Wu  1 , Rui Zhang  1 , Tingli Wang  1 , Jiali Wang  1 , Yitao Zhu  1 , Ruikun Guo  1 , Huan Xu  2 , Lin Li  2 , Mark E Cooper  3 , Fang Liu  1
Affiliations

Association between atherosclerotic cardiovascular diseases risk and renal outcome in patients with type 2 diabetes mellitus

Honghong Ren et al. Ren Fail. 2021 Dec.

Abstract

Aims: Chronic kidney disease (CKD) and diabetes mellitus increase atherosclerotic cardiovascular diseases (ASCVD) risk. However, the association between renal outcome of diabetic kidney disease (DKD) and ASCVD risk is unclear.

Methods: This retrospective study enrolled 218 type 2 diabetic patients with biopsy-proven DKD, and without known cardiovascular diseases. Baseline characteristics were obtained and the 10-year ASCVD risk score was calculated using the Pooled Cohort Equation (PCE). Renal outcome was defined as progression to end-stage renal disease (ESRD). The association between ASCVD risk and renal function and outcome was analyzed with logistic regression and Cox analysis.

Results: Among all patients, the median 10-year ASCVD risk score was 14.1%. The median of ASCVD risk score in CKD stage 1, 2, 3, and 4 was 10.9%, 12.3%, 16.5%, and 14.8%, respectively (p = 0.268). Compared with patients with lower ASCVD risk (＜14.1%), those with higher ASCVD risk had lower eGFR, higher systolic blood pressure, and more severe renal interstitial inflammation. High ASCVD risk (>14.1%) was an independent indicator of renal dysfunction in multivariable-adjusted logistic analysis (OR, 3.997; 95%CI, 1.385-11.530; p = 0.010), though failed to be an independent risk factor for ESRD in patients with DKD in univariate and multivariate Cox analysis.

Conclusions: DKD patients even in CKD stage 1 had comparable ASCVD risk score to patients in CKD stage 2, 3, and 4. Higher ASCVD risk indicated severe renal insufficiency, while no prognostic value of ASVCD risk for renal outcome was observed, which implied macroangiopathy and microangiopathy in patients with DKD were related, but relatively independent.

Keywords: Atherosclerotic cardiovascular diseases; diabetes mellitus; diabetic kidney disease; end-stage renal disease renal biopsy.

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Conflict of interest statement

The authors declare no potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow chart of study participants.
Figure 2.
Figure 2.
Kaplan–Meier curve of enrolled patients.
See this image and copyright information in PMC

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