Association of renal function screening frequency with renal function decline in patients with type 2 diabetes: a real-world study in primary health care

Abstract

Aims To examine the association of the screening frequency of estimated glomerular filtration rate (eGFR) with the substantial reduction in eGFR (≥ 25%) among type 2 diabetes (T2D) patients with normal (eGFR≥60 ml/min/1.73 m2) and impaired kidney function (eGFR< 60 ml/min/1.73 m2). Methods A longitudinal study involving 5104 T2D patients with follow-up period of 6.8 years (1.9 SD) were treated at the Rovaniemi Health Center, Rovaniemi, Finland during 2011–2019. The association between the screening frequency of eGFR (yearly vs. non-yearly) and the substantial reduction in eGFR was studied with logistical models and adjusted with biochemical variables and preventive medications. Results Among the T2D patients with normal kidney function, non-yearly eGFR screening was significantly associated with substantial eGFR reduction in both unadjusted (odds ratio [OR] 3.29, 95% confidence interval [CI] 2.54–4.33) and adjusted models (OR 2.06, 95% CI 1.21–3.73) compared with yearly screening frequency. In the group of patients with impaired kidney function in the unadjusted model, non-yearly eGFR screening was significantly associated with substantial eGFR reduction (OR 2.38, 95% CI 1.30–4.73), but became non-significant after adjustments (OR 1.89, 95% CI 0.61–7.21). Conclusions This study underscores the role of regular eGFR screening in the prevention of kidney function decline.

Data-driven subgroups of prediabetes and the associations with outcomes in Chinese adults

“… 29 The composite outcome of CKD included incident kidney failure requiring dialysis or replacement therapy, death due to renal causes, decline in eGFR defined as eGFR <60 mL/min/1.73 m 2 at follow-up or a certain drop in eGFR category (from eGFR ≥90 mL/min/1.73 m 2 at baseline to eGFR in 60–89 mL/min/1.73 m 2 at follow-up) accompanied by a 25% or greater reduction in eGFR from baseline. 30 , 31 Decline in eGFR was calculated as (eGFR at baseline - eGFR follow-up)/eGFR at baseline×100%. Major CVD events in the present study included the first nonfatal myocardial infarction, nonfatal stroke, hospitalization or treatment for heart failure that occurred during follow-up, and cardiovascular death.…”