Objective: To explore the renal function decline and the related risk factors in a cohort of Beijing Community Diabetes Study.

Methods: A multi-center, prospective study with ten-year follow-up was conducted at Beijing communities between 2008 and 2018. The clinical information and physical examination were recorded. Laboratory test including hemoglobin A1c, serum uric acid, fasting blood glucose, serum creatinine, and blood lipid profile were conducted. The patients were divided into two groups according to their age (<65 and ≧ 65). Annual eGFR decline rate≧3ml/min/1.73m2 was defined as rapid renal function decline. The tendency of renal function change over 10 years in different age groups had been described. Logistic multivariable models were employed to investigate the risk factors of rapid renal function decline.

Results: A total of 1655 patients with type 2 diabetes were enrolled. The median (quartile1, quartile3) annual rate of decline in eGFR of T2DM was 0.21(-2.51, 3.06) ml/min/1.73m2. Among them, 25.5% of the patients (n=422) showed rapid GFR decline, with an annual decrease of 5.28(3.85, 7.46) ml/min/1.73m2. Non-rapid decliner was 74.5% (n=1233), and the annual decrease was -0.99(-3.66, 0.82) ml/min/1.73m2. The patients with end-stage renal disease increased from 0.12% to 0.91% compared with the baseline. Uric acid was an independent risk factor for rapid GFR decline in both non-elder (OR=1.01, 95%CI: 1.00-1.01, P=0.001) and elder population (OR=1.01, 95%CI: 1.00-1.01, P=0.002), adjusting for age, sex and duration. Hyperfiltration was another independent risk factor for rapid GFR decline in non-elder (OR=14.72, 95%CI: 8.97-24.15, P<0.001) and elder population (OR=7.91, 95%CI: 4.04-15.48, P<0.001).

Conclusions: A quarter of patients with type 2 diabetes showed rapid renal function decline over 10 years. Serum uric acid and glomerular hyperfiltration are independent risk factors to rapid renal function decline.


M. Yuan: None. S. Yuan: None.


Capital Health Research and Development (2016-1-2057)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.