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Diabetes and Trajectories of Estimated Glomerular Filtration Rate: A Prospective Cohort Analysis of the Atherosclerosis Risk in Communities Study.

TitleDiabetes and Trajectories of Estimated Glomerular Filtration Rate: A Prospective Cohort Analysis of the Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsWarren B, Rebholz CM, Sang Y, Lee AK, Coresh JJ, Selvin E
Secondary AuthorsGrams ME
JournalDiabetes Care
Volume41
Issue8
Pagination1646-1653
Date Published2018 08
ISSN1935-5548
KeywordsAged, Atherosclerosis, Blood Pressure, Cohort Studies, Diabetes Complications, Diabetes Mellitus, Disease Progression, Female, Glomerular Filtration Rate, Humans, Hypertension, Kidney, Male, Middle Aged, Renal Insufficiency, Chronic, Residence Characteristics, Risk Factors
Abstract

OBJECTIVE: To characterize long-term kidney disease trajectories in persons with and without diabetes in a general population.

RESEARCH DESIGN AND METHODS: We classified 15,517 participants in the community-based Atherosclerosis Risk in Communities (ARIC) study by diabetes status at baseline (1987-1989; no diabetes, undiagnosed diabetes, and diagnosed diabetes). We used linear mixed models with random intercepts and slopes to quantify estimated glomerular filtration rate (eGFR) trajectories at four visits over 26 years.

RESULTS: Adjusted mean eGFR decline over the full study period among participants without diabetes was -1.4 mL/min/1.73 m/year (95% CI -1.5 to -1.4), with undiagnosed diabetes was -1.8 mL/min/1.73 m/year (95% CI -2.0 to -1.7) (difference vs. no diabetes,

CONCLUSIONS: Diabetes is an important risk factor for kidney function decline. Those with diagnosed diabetes declined almost twice as rapidly as those without diabetes. Among people with diagnosed diabetes, steeper declines were seen in those with modifiable risk factors, including hypertension and glycemic control, suggesting areas for continued targeting in kidney disease prevention.

DOI10.2337/dc18-0277
Alternate JournalDiabetes Care
PubMed ID29858211
PubMed Central IDPMC6054502
Grant ListR01 DK089174 / DK / NIDDK NIH HHS / United States
K01 DK107782 / DK / NIDDK NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
K24 DK106414 / DK / NIDDK NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
K08 DK092287 / DK / NIDDK NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States