Physicians' Academy for Cardiovascular Education

Differential associations of eGFR and UACR with CVD subtypes in patients with diabetes

News - Sep. 29, 2021

Kidney function measures and cardiovascular outcomes in people with diabetes: the Hoorn Diabetes Care System cohort

Presented at the EASD 2021 by: Elisa Dal Canto, MD - Amsterdam, The Netherlands

Introduction and methods

It has been well established that the kidney function measures eGFR and albuminuria independently predict CVD. In HFpEF, albuminuria and eGFR are differently associated with distinct cardiac phenotypes. This raised the question whether there are differential association between each manifestation of kidney disease in diabetes (atherosclerotic vs. non-atherosclerotic) and types of CVD. In addition, the impact of longitudinal changes of kidney function measures on CVD risk is not well understood.

In this study, data of the cohort of the Hoorn Diabetes Care System were used consisting of >14,000 patients with diabetes with information of annually collected measurements on CV risk factors, microvascular complications and CV events. 13,657 Patients with diabetes were included in this study. Median follow-up was 7 years.

Main results


In this study of diabetes patients in the Hoorn Diabetes Care System, longitudinal decrease of eGFR was associated with higher risk of MI, CHD and stroke. Moreover, longitudinal increase of UACR was associated with higher risk of CV mortality, higher risk of HF in women but not in men, and a higher risk of MI and CHD but only when UACR was >30 mg/mmol.

When discussing the findings of this study, Dal Canto raised some questions: Do eGFR and UACR play distinct role in CV pathophysiology? And what would be the incremental value of eGFR and UACR when added to CV risk score for the prediction of CV outcomes in patients with diabetes?

- Our reporting is based on the information provided at the EASD Virtual Meeting–

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