Visual Abstract

Objective: Rapid glomerular filtration rate (GFR) decline, increased hemoglobin A1c (HbA1c) and hyperfiltration were risk factors for renal function decline. We aimed to explore the effect of HbA1c decline on short-term GFR decline in patients with type 2 diabetes (T2D).

Methods: A total of 3920 patients were enrolled if they had 2-3 times HbA1c and eGFR test in 12 months. Of them, 16.7%, 29.4%, 12.5%, 14.1% and 27.3 had relatively stable (RS:- 3.49~3.49), rapid decline (RD:> - 10.00), modest decline (MD:- 10.00~3.50), modest increase (3.50~10.00) and rapidly increase (>10.00) of eGFR (mL/min/1.73 m2) respectively. The final analysis comprised 2295 patients in group RS, RD and MD.

Results: Multinomial logistic regression analysis showed HbA1c decline of ≥-3.10% [OR:2.251 (95%CI: 1.316~3.850)], -3.00~-2.10% [OR: 1.962 (95%CI: 1.160~3.316)], -2.00~-1.10% [OR:1.592 (95%CI: 1.089~2.329)], stage G1 (eGFR≥90) [OR: 4.111 (95%CI: 3.043~5.552)] and stage A3 UACR [OR: 1.819 (95%CI: 1.070~3.093)] were major risk factors for GFR RD. No significant risk factors were found to be related with GFR MD (Table).

Conclusions: High proportion of patients with T2D experienced short term eGFR RD or RI. Decline of HbA1c (≥-1.10%) and being at stage G1 or A3 were risk factors for eGFR RD. The eGFR accompanied by HbA1c decline may indicate the real renal function.


L. An: None. L. Ji: None.

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