Diabetes and Chronic Kidney Disease Increase Risk of Death and Cardiovascular Events

Strategic Insights -

A recent study involving 57,946 patients with type 2 diabetes has found that diabetes and chronic kidney disease (CKD) are independent predictors of death and cardiovascular events. The study, conducted by AstraZeneca, aimed to characterize the effect of estimated glomerular filtration rate (eGFR) and other factors on the risk of death and cardiovascular events in patients with type 2 diabetes. The researchers found that a low eGFR was associated with an increased risk of death, myocardial infarction (MI), and ischemic stroke or transient ischemic attack (IS/TIA).

Key Takeaways:

  • A cohort of 57,946 patients with type 2 diabetes was identified from The Health Improvement Network, a UK primary care database, and followed for a mean of 6.76 years.
  • The incidence rates of death, MI, and IS/TIA were calculated overall and by eGFR category at baseline, with a low eGFR (15-29 mL/min) associated with an increased risk of death (HR: 2.79; 95% CI: 2.57-3.03), MI (HR: 2.33; 95% CI: 1.89-2.87), and IS/TIA (HR: 1.77; 95% CI: 1.43-2.18) relative to eGFR = 60 mL/min.
  • Other predictors of death, MI, and IS/TIA included age, longer duration of diabetes, poor control of diabetes, hyperlipidemia, smoking, and a history of cardiovascular events.
  • The researchers concluded that in patients with type 2 diabetes, management of cardiovascular risk factors and careful monitoring of eGFR may represent opportunities to reduce the risks of death, MI, and IS/TIA.
  • The study highlights the importance of managing cardiovascular risk factors and monitoring kidney function in patients with type 2 diabetes.

Statistics:

  • Mean follow-up time of 6.76 years
  • Overall incidence rates of death: 43.65 cases per 1000 person-years
  • Overall incidence rates of MI: 9.26 cases per 1000 person-years
  • Overall incidence rates of IS/TIA: 10.39 cases per 1000 person-years
  • Hazard ratio (HR) for death associated with low eGFR (15-29 mL/min): 2.79 (95% CI: 2.57-3.03)
  • Hazard ratio (HR) for MI associated with low eGFR (15-29 mL/min): 2.33 (95% CI: 1.89-2.87)
  • Hazard ratio (HR) for IS/TIA associated with low eGFR (15-29 mL/min): 1.77 (95% CI: 1.43-2.18)

Sources:

  • Cardiovascular events and all-cause mortality in a cohort of 57,946 patients with type 2 diabetes: associations with renal function and cardiovascular risk factors. Cardiovascular Diabetology, 2015;14():1-15.
  • AstraZeneca R&D, Molndal, Sweden.
  • Biomed Central Ltd, 236 Grays Inn Rd, Floor 6, London WC1X 8HL, England.