Renal function and attributable risk of death and cardiovascular hospitalization in participants with diabetes from a registry-based cohort

Aims: To estimate the attributable risk of renal function on all-cause mortality and cardiovascular hospitalization in patients with diabetes. Methods: A prospective cohort study in 19,469 adults with diabetes, free of cardiovascular disease, attending primary care in Spain (2008-2011). The estimated glomerular filtration rate (eGFR) and other variables were collected and patients were followed to the first hospitalization for coronary or stroke event, or death, until the end of 2012. The cumulative incidence of the study endpoints by eGFR categories was graphically displayed and adjusted population attributable risks (PARs) for low eGFR was calculated. Results: Mean follow-up was 3.2 years and 506 deaths and 1720 hospitalizations were recorded. The cumulative risk for the individual events increased as eGFR levels decreased. The PAR associated with having an eGFR of 60 mL/min/1.73 m(2) or less was 11.4% (95% CI 4.8-18.3) for all-cause mortality, 9.2% (95% CI 5.3-13.4) for coronary heart disease, and 2.6% (95% CI -1.8 to 7.4) for stroke. Conclusions: Reduced eGFR levels were associated with a larger proportion of avoidable deaths and cardiovascular hospitalizations in people with diabetes compared to previously reported results in people with other cardiovascular risk factors. (C) 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study aimed to estimate the attributable risk of renal function on all-cause mortality and cardiovascular hospitalization in diabetes patients. The results showed that reduced eGFR levels were associated with a higher risk of avoidable deaths and cardiovascular hospitalizations, with PARs of 11.4% for all-cause mortality, 9.2% for coronary heart disease, and 2.6% for stroke when eGFR was 60 mL/min/1.73 m(2) or lower.