Death, CV risks increase with reduced renal function in diabetics

Poor renal function contributes to a significant burden of disease in patients with diabetes, such that estimated glomerular filtration rate (eGFR) levels <90 mL/min/1.73 m² are associated with increased mortality and cardiovascular (CV) hospitalizations, a study reports.

The study included 19,469 adults with diabetes, of whom 83.2 percent had hypertension, 85.9 percent had dyslipidaemia, 49.6 percent were obese, and 21.7 percent were current smokers. The eGFR level was <60 mL/min/1.73 m² in 2,868 (14.7 percent) individuals, with 810 (4.2 percent) having even lower eGFR levels (≤45 mL/min/1.73 m²).

Patients with lower eGFR were older, predominantly women, and more likely to be obese and have arterial hypertension and dyslipidaemia. They also had lower levels of good cholesterol and were less likely to smoke.

Over a mean follow-up of 3.2 years, 506 deaths, 925 hospitalizations for coronary heart disease (CHD), and 795 hospitalizations for stroke were recorded. Notably, the cumulative risk of the individual events increased as eGFR levels decreased.

The population attributable risk associated with having an eGFR of ≤60 mL/min/1.73 m² was 11.4 percent (95 percent confidence interval [CI], 4.8–18.3) for all-cause mortality, 9.2 percent (95 percent CI, 5.3–13.4) for CHD, and 2.6 percent (95 percent CI, 1.8–7.4) for stroke.

The present data underscore the need to intensify primary cardiovascular disease prevention and control in patients with diabetes, the researchers said.