Glomerular filtration rate and albuminuria predict ... - Springer Link
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CARDIO VASCULAR DIABETOLOGY
Cox et al. Cardiovascular Diabetology 2013, 12:68 http://www.cardiab.com/content/12/1/68
ORIGINAL INVESTIGATION
Open Access
Glomerular filtration rate and albuminuria predict mortality independently from coronary artery calcified plaque in the Diabetes Heart Study Amanda J Cox1,2,3, Fang-Chi Hsu4, J Jeffrey Carr5, Barry I Freedman6 and Donald W Bowden1,2,3*
Abstract Background: Risk stratification in individuals with type 2 diabetes (T2D) remains an important priority in the management of associated morbidity and mortality, including from cardiovascular disease (CVD). The current investigation examined whether estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (UACR) were independent predictors of CVD-mortality in European Americans (EAs) with T2D after accounting for subclinical CVD. Methods: The family-based Diabetes Heart Study (DHS) cohort (n=1,220) had baseline measures of serum creatinine, eGFR, UACR and coronary artery calcified plaque (CAC) assessed by non-contrast computed tomography scan. Cox proportional hazards regression was performed to determine risk for all-cause mortality and CVD-mortality associated with indices of kidney disease after accounting for traditional CVD risk factors and CAC as a measure of subclinical CVD. Results: Participants were followed for 8.2±2.6 years (mean±SD) during which time 247 (20.9%) were deceased, 107 (9.1%) from CVD. Univariate analyses revealed positive associations between serum creatinine (HR:1.56; 95% CI: 1.37–1.80; p0.0001) and negative associations between serum albumin (0.74; 0.65–0.84; p