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. 2024 Nov 18;24(1):3192.
doi: 10.1186/s12889-024-20715-2.

Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study

Shahi Kishor #  1   2   3   4 , Jianrong Chen #  1   2   3   4 , Yan Zhang  1   2   3   4 , Wei Liu  1   2   3   4 , Lingyan Zhu  1   2   3   4 , Jixiong Xu  5   6   7   8 , Jiancheng Wang  9   10   11   12
Affiliations

Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study

Shahi Kishor et al. BMC Public Health. .

Abstract

Objective: We evaluated the interaction of urinary protein-to-creatinine ratio (UPCR) with diabetes on the risk of cardiovascular events in a cohort study.

Methods: The study population consisted of 639 participants with chronic kidney disease (CKD) stages 2-5, enrolled between 2010 and 2011 in Japan. Cox proportional hazards models were used to evaluate the independent and combined effects of the UPCR and diabetes on cardiovascular events.

Results: During a median follow-up of 3 years, 59 participants developed cardiovascular events during follow-up. A notably higher risk of cardiovascular events was found in participants with proteinuria [hazards ratio (HR): 2.16, 95% confidence interval (95% CI): 1.17-3.97] compared to those without proteinuria at UPCR levels. In addition, the participants with diabetes had a higher risk of cardiovascular events (HR: 2.53, 95% CI: 1.49-4.30) than those without diabetes. Moreover, an interaction was found between UPCR and diabetes on cardiovascular events (P for interaction = 0.04). Participants with both proteinuria (UPCR ≥ 0.5 g/gCr) and diabetes had a 4.09 times higher risk of cardiovascular events (HR: 4.09, 95% CI: 1.97-8.47) compared with those without proteinuria (UPCR < 0.5 g/gCr) and diabetes.

Conclusions: In summary, among participants with CKD stages 2-5, proteinuria and diabetes were found to independently and jointly affect the risk of cardiovascular events. Participants with proteinuria and diabetes had the highest risk of cardiovascular events compared with other groups.

Keywords: Cardiovascular disease; Chronic kidney disease; Diabetes; Proteinuria; Urinary protein-to-creatinine ratio.

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Conflict of interest statement

Declarations Ethics approval and consent to participate In the previously published article, Iimori S et al. [12] has clearly stated that: This study was approved by the ethical committees of Tokyo Medical and Dental University, School of Medicine (No. 883) and all institutions participating in the study and was conducted in accordance with the ethical principles of the Declaration of Helsinki. All patients provided informed consent. Consent for publication Not applicable. Competing interests The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves of cumulative hazards of CV events by baseline urinary protein-to-creatinine ratio (<0.5, ≥ 0.5 g/gCr) and diabetes status (yes, no) on the risk of CV events
Fig. 2
Fig. 2
CV events after 3 years of follow-up by categories of UPCR (<0.5, ≥ 0.5 g/gCr) and diabetes status (yes, no) at baseline
See this image and copyright information in PMC

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