The number of nephroprotection targets attained is associated with cardiorenal outcomes and mortality in patients with diabetic kidney disease. The CKD‐REIN cohort study
BONNET, Fabrice
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bordeaux population health [BPH]
Global Health in the Global South [GHiGS]
Service d'endocrinologie diabétologie et nutrition [Rennes]
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Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bordeaux population health [BPH]
Global Health in the Global South [GHiGS]
Service d'endocrinologie diabétologie et nutrition [Rennes]
BONNET, Fabrice
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bordeaux population health [BPH]
Global Health in the Global South [GHiGS]
Service d'endocrinologie diabétologie et nutrition [Rennes]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Bordeaux population health [BPH]
Global Health in the Global South [GHiGS]
Service d'endocrinologie diabétologie et nutrition [Rennes]
COMBE, Christian
Bioingénierie tissulaire [BIOTIS]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
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Bioingénierie tissulaire [BIOTIS]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
FRIMAT, Luc
Adaptation, mesure et évaluation en santé. Approches interdisciplinaires [APEMAC]
Service de Néphrologie [CHRU Nancy]
Centre d'investigation clinique [Nancy] [CIC]
Adaptation, mesure et évaluation en santé. Approches interdisciplinaires [APEMAC]
Service de Néphrologie [CHRU Nancy]
Centre d'investigation clinique [Nancy] [CIC]
LAVILLE, Maurice
Cardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
Association pour l'Utilisation du Rein Artificiel Région Lyonnaise [AURAL]
Cardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
Association pour l'Utilisation du Rein Artificiel Région Lyonnaise [AURAL]
LIABEUF, Sophie
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
CHU Amiens-Picardie
Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
CHU Amiens-Picardie
MASSY, Ziad
Centre de recherche en épidémiologie et santé des populations [CESP]
Hôpital Ambroise Paré [AP-HP]
Centre de recherche en épidémiologie et santé des populations [CESP]
Hôpital Ambroise Paré [AP-HP]
FOUQUE, Denis
Cardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
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Cardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Langue
EN
Article de revue
Ce document a été publié dans
Diabetes, Obesity and Metabolism. 2024-02-28
Résumé en anglais
Aim The risk of cardiorenal events remains high among patients with diabetes and chronic kidney disease (CKD), despite the prescription of recommended treatments. We aimed to determine whether the attainment of a combination ...Lire la suite >
Aim The risk of cardiorenal events remains high among patients with diabetes and chronic kidney disease (CKD), despite the prescription of recommended treatments. We aimed to determine whether the attainment of a combination of nephroprotection targets at baseline (glycated haemoglobin <7.0%, urinary albumin‐creatinine ratio <300 mg/g, blood pressure <130/80 mmHg, renin‐angiotensin system inhibition) was associated with better cardiorenal outcomes and lower mortality. Materials and Methods From the prospective French CKD‐REIN cohort, we studied 1260 patients with diabetes and CKD stages 3‐4 (estimated glomerular filtration rate: 15‐60 ml/min/1.73 m 2 ); 69% were men, and at inclusion, mean ± SD age: 70 ± 10 years; estimated glomerular filtration rate: 33 ± 11 ml/min/1.73 m 2 . The median follow‐up was 4.9 years. Results In adjusted Cox regression models, the attainment of two nephroprotection targets was consistently associated with a lower risk of cardiorenal events [hazard ratio 0.70 (95% confidence interval 0.57‐0.85)], incident kidney failure with replacement therapy [0.58 (0.43‐0.77)], four major adverse cardiovascular events (cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure) [0.75 (0.57‐0.99)] and all‐cause mortality [0.59 (0.42‐0.82)] when compared with the attainment of zero or one target. For patients with a urinary albumin‐creatinine ratio ≥300 mg/g, those who attained at least two targets had lower hazard ratios for cardiorenal events [0.61 (0.39‐0.96)], four major adverse cardiovascular events [0.53 (0.28‐0.98)] and all‐cause mortality [0.35 (0.17‐0.70)] compared with those who failed to attain any targets. Conclusions These findings suggest that the attainment of a combination of nephroprotection targets is associated with better cardiorenal outcomes and a lower mortality rate in people with diabetic kidney disease.< Réduire
Mots clés en anglais
cardiovascular disease
diabetic nephropathy
pharmaco-epidemiology
type 2 diabetes