期刊
DIABETES RESEARCH AND CLINICAL PRACTICE
卷 138, 期 -, 页码 8-15出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.diabres.2017.11.003
关键词
Creatinine; Albuminuria; Type 2 Diabetes; Diabetic nephropathy
资金
- Alexandra Health Grant [AHPL SIGII/11001, SIG/11029, SIG/12024]
- National Medical Research Council Grant (NMRC/PPG/AH(KTPH))
- National Medical Research Council Grant [NMRC/CIRG/1398/2014]
Aim: We aim to study association serum creatinine(cr) variability and albuminuria progression. Methods: We conducted a retrospective cohort study on patients with Type 2 Diabetes Mellitus at a Diabetes Centre in Singapore (discovery cohort). Outcome is worsening of urinary albumin-to-creatinine(ACR) across stages. Cr variability was expressed as adjusted cr-intrapersonal standard deviation(SD) and coefficient-of-variation(cr-CV). A separate cohort was used for validating association between cr variability and albuminuria progression (validation cohort). Results: Over median follow-up of 4.2 years, 38.4% of 636 patients had albuminuria progression in the discovery cohort. Increasing log-transformed adjusted cr-intrapersonal SD and cr-CV were significantly associated with albuminuria progression: HRs 1.43 (95% CI 1.11-1.85) and 1.44 (1.11-1.87) respectively in the discovery cohort, and HRs 1.94 (1.09-3.45) and 1.91 (1.05-3.45) respectively in the validation cohort. When stratified by baseline urinary ACR, higher cr variability was significantly associated with albuminuria progression in patients with normoalbuminuria but not microalbuminuria. Conclusions: Cr variability independently predicts albuminuria onset. This is evident in patients with normoalbuminuria, suggesting that higher cr variability could herald albuminuria onset. (C) 2017 Published by Elsevier Ireland Ltd.
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