Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes

Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background According to studies by the National Kidney Foundation and Food and Drug Administration, 30% and 40% declines in estimated glomerular filtration rate (eGFR) could be used as surrogate endpoints of end-stage renal disease (ESRD). However, the benefits of using these endpoints in diabetic patients remain unclear. Methods This cohort study comprised Japanese patients with type 2 diabetes; those with repeated serum creatinine measurements during a baseline period of 2 years (n = 1868) or 3 years (n = 2001) were enrolled. Subsequent risks of ESRD following eGFR declines were assessed. Results In the 2-year baseline analysis, the cumulative prevalence of −20%, −30%, −40%, and −53% changes in eGFR were 23.9%, 11.1%, 6.8%, and 3.7%, respectively. There were 133 cases (7.1%) of subsequent ESRD during a median follow-up period of 6.5 years. In the 3-year baseline analysis, the corresponding proportions were 28.1%, 14.0%, 7.7%, and 3.9%, respectively, with 110 participants (5.5%) reaching ESRD during a median follow-up period of 5.5 years. The adjusted hazard ratios of subsequent ESRD following −53%, −40%, −30%, and −20% changes in eGFR during the 2-year baseline period were 22.9 (11.1–47.3), 12.8 (6.9–23.7), 8.2 (4.3–15.5), and 3.9 (2.2–7.0), respectively when compared with the no changes in eGFR. In the 3-year baseline analysis, the corresponding risks were 29.7 (10.8–81.9), 18.4 (7.6–44.7), 12.8 (5.2–32.2), and 5.4 (2.3–12.8), respectively. In the subgroup analysis, similar trends were observed in patients with macroalbuminuria at baseline. Conclusions Declines in eGFR were strongly associated with subsequent risk of ESRD in Japanese type 2 diabetic patients. In addition to 30% and 40% declines, a 20% decline in eGFR over 2 years could be considered as a candidate surrogate endpoint of ESRD in diabetic kidney disease.

Original languageEnglish
Article numbere0201535
JournalPloS one
Volume13
Issue number8
DOIs
Publication statusPublished - Aug 1 2018

Fingerprint

glomerular filtration rate
Medical problems
kidney diseases
Glomerular Filtration Rate
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
Chronic Kidney Failure
endpoints
Biomarkers
Diabetic Nephropathies
United States Food and Drug Administration
risk analysis
cohort studies
Creatinine
creatinine
Cohort Studies
Hazards
Kidney
kidneys
Serum

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan (2018). Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes. PloS one, 13(8), [e0201535]. https://doi.org/10.1371/journal.pone.0201535

Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes. / Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan.

In: PloS one, Vol. 13, No. 8, e0201535, 01.08.2018.

Research output: Contribution to journalArticle

Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan 2018, 'Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes', PloS one, vol. 13, no. 8, e0201535. https://doi.org/10.1371/journal.pone.0201535
Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan. Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes. PloS one. 2018 Aug 1;13(8). e0201535. https://doi.org/10.1371/journal.pone.0201535
Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan. / Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes. In: PloS one. 2018 ; Vol. 13, No. 8.
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title = "Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes",
abstract = "Background According to studies by the National Kidney Foundation and Food and Drug Administration, 30{\%} and 40{\%} declines in estimated glomerular filtration rate (eGFR) could be used as surrogate endpoints of end-stage renal disease (ESRD). However, the benefits of using these endpoints in diabetic patients remain unclear. Methods This cohort study comprised Japanese patients with type 2 diabetes; those with repeated serum creatinine measurements during a baseline period of 2 years (n = 1868) or 3 years (n = 2001) were enrolled. Subsequent risks of ESRD following eGFR declines were assessed. Results In the 2-year baseline analysis, the cumulative prevalence of −20{\%}, −30{\%}, −40{\%}, and −53{\%} changes in eGFR were 23.9{\%}, 11.1{\%}, 6.8{\%}, and 3.7{\%}, respectively. There were 133 cases (7.1{\%}) of subsequent ESRD during a median follow-up period of 6.5 years. In the 3-year baseline analysis, the corresponding proportions were 28.1{\%}, 14.0{\%}, 7.7{\%}, and 3.9{\%}, respectively, with 110 participants (5.5{\%}) reaching ESRD during a median follow-up period of 5.5 years. The adjusted hazard ratios of subsequent ESRD following −53{\%}, −40{\%}, −30{\%}, and −20{\%} changes in eGFR during the 2-year baseline period were 22.9 (11.1–47.3), 12.8 (6.9–23.7), 8.2 (4.3–15.5), and 3.9 (2.2–7.0), respectively when compared with the no changes in eGFR. In the 3-year baseline analysis, the corresponding risks were 29.7 (10.8–81.9), 18.4 (7.6–44.7), 12.8 (5.2–32.2), and 5.4 (2.3–12.8), respectively. In the subgroup analysis, similar trends were observed in patients with macroalbuminuria at baseline. Conclusions Declines in eGFR were strongly associated with subsequent risk of ESRD in Japanese type 2 diabetic patients. In addition to 30{\%} and 40{\%} declines, a 20{\%} decline in eGFR over 2 years could be considered as a candidate surrogate endpoint of ESRD in diabetic kidney disease.",
author = "{Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan} and Megumi Oshima and Tadashi Toyama and Masakazu Haneda and Kengo Furuichi and Tetsuya Babazono and Hiroki Yokoyama and Kunitoshi Iseki and Shinichi Araki and Toshiharu Ninomiya and Shigeko Hara and Yoshiki Suzuki and Masayuki Iwano and Eiji Kusano and Tatsumi Moriya and Hiroaki Satoh and Hiroyuki Nakamura and Miho Shimizu and Akinori Hara and Hirofumi Makino and Takashi Wada",
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T1 - Estimated glomerular filtration rate decline and risk of end-stage renal disease in type 2 diabetes

AU - Research Group of Diabetic Nephropathy, Ministry of Health, Labour, and Welfare of Japan

AU - Oshima, Megumi

AU - Toyama, Tadashi

AU - Haneda, Masakazu

AU - Furuichi, Kengo

AU - Babazono, Tetsuya

AU - Yokoyama, Hiroki

AU - Iseki, Kunitoshi

AU - Araki, Shinichi

AU - Ninomiya, Toshiharu

AU - Hara, Shigeko

AU - Suzuki, Yoshiki

AU - Iwano, Masayuki

AU - Kusano, Eiji

AU - Moriya, Tatsumi

AU - Satoh, Hiroaki

AU - Nakamura, Hiroyuki

AU - Shimizu, Miho

AU - Hara, Akinori

AU - Makino, Hirofumi

AU - Wada, Takashi

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background According to studies by the National Kidney Foundation and Food and Drug Administration, 30% and 40% declines in estimated glomerular filtration rate (eGFR) could be used as surrogate endpoints of end-stage renal disease (ESRD). However, the benefits of using these endpoints in diabetic patients remain unclear. Methods This cohort study comprised Japanese patients with type 2 diabetes; those with repeated serum creatinine measurements during a baseline period of 2 years (n = 1868) or 3 years (n = 2001) were enrolled. Subsequent risks of ESRD following eGFR declines were assessed. Results In the 2-year baseline analysis, the cumulative prevalence of −20%, −30%, −40%, and −53% changes in eGFR were 23.9%, 11.1%, 6.8%, and 3.7%, respectively. There were 133 cases (7.1%) of subsequent ESRD during a median follow-up period of 6.5 years. In the 3-year baseline analysis, the corresponding proportions were 28.1%, 14.0%, 7.7%, and 3.9%, respectively, with 110 participants (5.5%) reaching ESRD during a median follow-up period of 5.5 years. The adjusted hazard ratios of subsequent ESRD following −53%, −40%, −30%, and −20% changes in eGFR during the 2-year baseline period were 22.9 (11.1–47.3), 12.8 (6.9–23.7), 8.2 (4.3–15.5), and 3.9 (2.2–7.0), respectively when compared with the no changes in eGFR. In the 3-year baseline analysis, the corresponding risks were 29.7 (10.8–81.9), 18.4 (7.6–44.7), 12.8 (5.2–32.2), and 5.4 (2.3–12.8), respectively. In the subgroup analysis, similar trends were observed in patients with macroalbuminuria at baseline. Conclusions Declines in eGFR were strongly associated with subsequent risk of ESRD in Japanese type 2 diabetic patients. In addition to 30% and 40% declines, a 20% decline in eGFR over 2 years could be considered as a candidate surrogate endpoint of ESRD in diabetic kidney disease.

AB - Background According to studies by the National Kidney Foundation and Food and Drug Administration, 30% and 40% declines in estimated glomerular filtration rate (eGFR) could be used as surrogate endpoints of end-stage renal disease (ESRD). However, the benefits of using these endpoints in diabetic patients remain unclear. Methods This cohort study comprised Japanese patients with type 2 diabetes; those with repeated serum creatinine measurements during a baseline period of 2 years (n = 1868) or 3 years (n = 2001) were enrolled. Subsequent risks of ESRD following eGFR declines were assessed. Results In the 2-year baseline analysis, the cumulative prevalence of −20%, −30%, −40%, and −53% changes in eGFR were 23.9%, 11.1%, 6.8%, and 3.7%, respectively. There were 133 cases (7.1%) of subsequent ESRD during a median follow-up period of 6.5 years. In the 3-year baseline analysis, the corresponding proportions were 28.1%, 14.0%, 7.7%, and 3.9%, respectively, with 110 participants (5.5%) reaching ESRD during a median follow-up period of 5.5 years. The adjusted hazard ratios of subsequent ESRD following −53%, −40%, −30%, and −20% changes in eGFR during the 2-year baseline period were 22.9 (11.1–47.3), 12.8 (6.9–23.7), 8.2 (4.3–15.5), and 3.9 (2.2–7.0), respectively when compared with the no changes in eGFR. In the 3-year baseline analysis, the corresponding risks were 29.7 (10.8–81.9), 18.4 (7.6–44.7), 12.8 (5.2–32.2), and 5.4 (2.3–12.8), respectively. In the subgroup analysis, similar trends were observed in patients with macroalbuminuria at baseline. Conclusions Declines in eGFR were strongly associated with subsequent risk of ESRD in Japanese type 2 diabetic patients. In addition to 30% and 40% declines, a 20% decline in eGFR over 2 years could be considered as a candidate surrogate endpoint of ESRD in diabetic kidney disease.

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