Background: There is discordance between the presence of albuminuria and the decline in renal function. This study aimed to assess the role of baseline Urine Albumin-to-Creatinine Ratio (UACR) and the estimated glomerular filtration rate (eGFR) in the development of advanced chronic kidney disease (CKD; GFR < 60 mL/minute per 1.73 m2) in type 2 diabetic patients.
Methods: A total of 2424 patients who had participated in a comprehensive diabetic care program were studied and were stratified into progressor (n=578) and non-progressor groups (n=1846) according to the status of progression to advanced CKD during the mean 8.4 years follow-up period.
Results: By Cox regression analysis, the risk of CKD progression [hazard ratio, HR (95% CI)] for patients with microalbuminuria and eGFR >90, non-albuminuria and eGFR 60~89 or microalbuminuria and eGFR 60~89 were 2.215 (1.592~3.081), 3.091 (2.354~4.059) and 4.351 (3.253~5.820), respectively (P<0.001 for all). By Kaplan-Meier survival curve, the progression rates were 9.4% in patients with non-albuminuria and eGFR >90, 25.6% in patients with microalbuminuria and eGFR >90, 28.0% in patients with non-albuminuria and eGFR 60~89 and 38.5% in patients with microalbuminuria and eGFR 60~89.
Conclusions: Our study demonstrated that type 2 diabetic patients with microalbuminuria and eGFR >90 or patients with non-albuminuria and eGFR level of 60~89 were associated with similar risk of progression to advanced CKD.
L. An: None. H. Hsu: None. Y. Chang: None. T. Lee: None.