Heterogeneity in the Association Between Prediabetes Categories and Development of Impaired Renal Function in A 5-Year Follow-Up 

Abstract

Background: Impaired renal function (IRF) in patients with diabetes impose a significant health burden. This study evaluates the association of three diagnostic categories of with a reduction on glomerular filtration rate Methods: We used data from PREDAPS prospective study a cohort of 1072 subjects with prediabetes and another cohort of 772 subjects without prediabetes were follow-up from 2012 to 2017. Prediabetes was defined according to American Association of Diabetes (ADA) criteria. IRF was defined as having a glomerular filtration rate < 60 mL/min/1.73 m2. Incidence rate of IRF according to prediabetes and diagnostic categories of prediabetes as well as Kaplan Meir figures were calculated. Hazard ratios (HR) for the association of the prediabetes diagnostic categories of prediabetes with IRF, adjusting for potential confounders, were estimated by Cox regression models.Results: IRF Incidence rate per 100 person-years in subjects without prediabetes was 1.72 (95% confidence interval [CI]: 1.34-2.21) and 1.79 (95%CI: 1.45-2.20) for those with prediabetes stage, log rank test p= 0.84. Prediabetes was associated with an adjusted HR of IRF onset of 0.76 (95% CI: 0. 54-1.07). Corresponding HR for diagnostic categories were 0.68 (95%CI:0.40-1.15) for those with both altered parameters, 0.68 (95%CI: 00.40-1.15) for those with only impaired HbA1c and 1.12 (95%CI: 0.68-1.85) for those with only impaired FPG. Conclusions: The present study reflects an overall trend towards a slightly decreased risk of IRF onset associated to prediabetes except for individuals with only isolated impaired FPG. Further studies are warranted to fully assess the renal progression of each group.