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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Predictors of cardiovascular events in patients with type 2 diabetic nephropathy and hypertension: A case for albuminuria
Kidney International, Supplement, Volume 66, No. 92, Year 2004
Notification
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Description
Individuals with type 2 diabetes and nephropathy represent a particularly high-risk group for both adverse cardiac as well as renal events. Using the Irbesartan in Diabetic Nephropathy Trial (IDNT) cohort, our objective was to determine baseline characteristics of individuals with type 2 diabetic nephropathy and hypertension predictive for cardiac events. IDNT identified 1715 individuals with type 2 diabetic nephropathy and hypertension having serum creatinine of 1.0 to 3.0 mg/dL and urinary albumin excretion rates ≥900 mg/day. A cardiovascular (CV) composite was used consisting of CV death, nonfatal MI, hospitalization for heart failure, stroke, amputation, and coronary and peripheral revascularization. Using multivariable Cox regression analysis, 41 baseline characteristics determined a priori were analyzed for their potential relationship to risk of experiencing a CV event. Of the 1715 individuals, 518 (30.2%) had at least one of the CV composite end points. Older age, male gender, longer duration of diabetes, history of cardiovascular disease, history of CHF, high urinary albumin:creatinine ratio, and low serum albumin were strong predictors for CV events; of these, prior history of CVD (RR 2.00, 95% CI 1.63-2.45; P < 0.0001) and high urinary albumin:creatinine ratio (RR 1.29 per natural log unit, 95% CI 1.13-1.48; P = 0.0002) at baseline were highly predictive for cardiovascular events. In conclusion, among individuals with hypertension and diabetic nephropathy, both the degree of albuminuria and lower serum albumin levels provide additional prognostic information concerning cardiovascular risk, in addition to traditional coronary risk factors. © 2004 by the International Society of Nephrology.
Authors & Co-Authors
Anavekar, Nagesh S.
Unknown Affiliation
Hunsicker, Lawrence G.
Unknown Affiliation
Rouleau, Jean-Lucien Lucien
Unknown Affiliation
Rosendorff, Clive
Unknown Affiliation
Drury, Paul Leslie
Unknown Affiliation
Raz, Itamar
Unknown Affiliation
Vanhille, Phillippe
Unknown Affiliation
Locatelli, Francesco
Unknown Affiliation
Goldhaber, Samuel Zachary
Unknown Affiliation
Pfeffer, Marc Allan
United States, Boston
Brigham and Women's Hospital
Statistics
Citations: 85
Authors: 10
Affiliations: 1
Identifiers
Doi:
10.1111/j.1523-1755.2004.09213.x
ISSN:
00986577
Research Areas
Noncommunicable Diseases
Study Design
Cohort Study
Study Approach
Quantitative
Participants Gender
Male