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. 2024 Aug 16;25(1):264.
doi: 10.1186/s12882-024-03699-4.

Variability of urinary albumin to creatinine ratio and eGFR are independently associated with eGFR slope in Japanese with type 2 diabetes: a three-year, single-center, retrospective cohort study

Takaaki Matsuda  1   2   3 , Yoshinori Osaki  4 , Kazushi Maruo  5 , Erika Matsuda  6   4 , Yasuhiro Suzuki  4   7 , Hiroaki Suzuki  4   8 , Bryan J Mathis  9 , Hitoshi Shimano  4 , Masakazu Mizutani  6
Affiliations

Variability of urinary albumin to creatinine ratio and eGFR are independently associated with eGFR slope in Japanese with type 2 diabetes: a three-year, single-center, retrospective cohort study

Takaaki Matsuda et al. BMC Nephrol. .

Abstract

Background: To evaluate the seasonal variability of urinary albumin to creatinine ratio (UACR) and eGFR and these effects on three-year eGFR slope in persons with type 2 diabetes (T2D).

Methods: A total of 1135 persons with T2D were analyzed in this single-center, retrospective cohort study in Japan. The standard deviation (SD) of UACR (SD [UACR]) and SD of eGFR (SD [eGFR]) were calculated for each person's 10-point data during the three years, and a multiple linear regression analysis was performed to evaluate associations with eGFR slope. A sensitivity analysis was performed in a group with no medication changes (n = 801).

Results: UACR exhibited seasonal variability, being higher in winter and lower in spring, early summer, and autumn especially in the UACR ≥ 30 mg/g subgroup, while eGFR showed no seasonal variability. The eGFR slope was significantly associated with SD (eGFR) (regression coefficient -0.170 [95% CI -0.189--0.151]) and SD (UACR) (0.000 [-0.001-0.000]). SGLT-2 inhibitors, baseline eGFR, and baseline systolic blood pressure (SBP) were also significantly associated. These associated factors, except baseline SBP, were still significant in the sensitivity analysis.

Conclusions: The UACR showed clear seasonal variability. Moreover, SD (UACR) and SD (eGFR) were independently associated with a three-year eGFR slope in persons with T2D.

Trial registration: This study was not registered for clinical trial registration because it was a retrospective observational study.

Keywords: Diabetes mellitus; Diabetic nephropathies; Seasonal variation; Type 2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study participants. UACR urinary albumin to creatinine ratio, DKD diabetic kidney disease
Fig. 2
Fig. 2
Seasonal variability of UACR and eGFR. Seasonal variability of UACR in all groups. A UACR < 30 mg/g (B) UACR 30–300 mg/g (C) UACR ≥ 300 mg/g. D Seasonal variability of eGFR in all groups. E UACR < 30 mg/g (F) UACR 30–300 mg/g (G) UACR ≥ 300 mg/g (H). The vertical axis in (A), (B), (C), and (D) represents the UACR value (mg/g) while the vertical axis in (E), (F), (G), and (H) represents the eGFR value (mL/min/1.73 m2). The horizontal axis represents a time series from January 2019 to February 2022. Error bars in the graphs represent 95% confidence intervals. The gray zone indicates winter months. *P < 0.05, **P < 0.01, and ***P < 0.001 vs. baseline. UACR urinary albumin to creatinine ratio, eGFR estimated glomerular filtration rate
See this image and copyright information in PMC

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