Association of Blood Glucose and Renal End Points in Advanced Diabetic Kidney Disease

Journal: 

Diabetes Res Clin Pract

publication year: 

2020

publication volume/issue: 

Jan 25:108011. doi: 10.1016/j.diabres.2020.108011

First author: 

Second author: 

Third author: 

Correspondence: 

Abstract: 

AIMS:
The association of blood glucose in advanced diabetic kidney disease (DKD) is unclear. This study investigated the association between blood glucose and renal endpoints in DKD patients.

METHODS:
This retrospective cohort study enrolled type 2 diabetic patients with advanced DKD with an estimated glomerular filtration rate (eGFR) between 30-90 ml/min/1.73 m2 and urine albumin-to-creatinine ratio (UACR) of 300-5000 mg/g. We classified patients into 2 groups according to their 1-year average HbA1c: <7% and >7%. We followed up the patients until the occurrence of primary renal endpoints.

RESULTS:
A total of 345 patients were included in the analysis for the period 2012-2018. Mean baseline eGFR was 58 ml/min/1.73 m2 and mean albuminuria levels were 1146 and 1313 mg/g, respectively. Median study duration was 3 years. The risk of primary renal endpoints was not decreased in patients with HbA1c less than 7% with an adjusted hazard ratio (aHR) of 0.62, 95% CI 0.26-1.45. The risks of persistent eGFR lower than 15 ml/min/1.73 m2 and doubling of serum creatinine level were similar between 2 group with aHR of 0.58 (95% CI 0.19-1.83) and 0.61 (95% CI 0.26-1.44), respectively.

CONCLUSIONS:
Intensive blood sugar control did not prevent renal failure in advanced DKD.