Presence of retinopathy and incident kidney and cardiovascular events in type 2 diabetes with normoalbuminuria - A post-hoc analysis of the PRIORITY randomized clinical trial

on the behalf of the PRIORITY Study Group

1 Citation (Scopus)

Abstract

Aims: Baseline diabetic retinopathy (DR) and risk of development of microalbuminuria, kidney function decline, and cardiovascular events (CVEs) in type 2 diabetes. Methods: Post-hoc analysis of the PRIORITY study including 1758 persons with type 2 diabetes and normoalbuminuria followed for a median of 2.5 (IQR: 2.0–3.0) years. DR diagnosis included non-proliferative and proliferative abnormalities, macular oedema, or prior laser treatment. Cox models were fitted to investigate baseline DR presence with development of persistent microalbuminuria (urinary albumin-creatinine ratio > 30 mg/g); chronic kidney disease (CKD) G3 (eGFR <60 ml/min/1.73m 2); and CVE. Models were adjusted for relevant risk factors. Results: At baseline, 304 (17.3 %) had DR. Compared to persons without DR, they were older (mean ± SD: 62.7 ± 7.7 vs 61.4 ± 8.3 years, p = 0.019), had longer diabetes duration (17.9 ± 8.4 vs. 10.6 ± 7.0 years, p < 0.001), and higher HbA 1c (62 ± 13 vs. 56 ± 12 mmol/mol, p < 0.001). The adjusted hazard ratios of DR at baseline for development of microalbuminuria (n = 197), CKD (n = 166), and CVE (n = 64) were: 1.50 (95%CI: 1.07, 2.11), 0.87 (95%CI: 0.56, 1.34), and 2.61 (95%CI: 1.44, 4.72), compared to without DR. Conclusions: Presence of DR in normoalbuminuric type 2 diabetes was associated with an increased risk of developing microalbuminuria and CVE, but not with kidney function decline.

Original languageEnglish
Article number108433
JournalJournal of Diabetes and its Complications
Volume37
Issue number4
Pages (from-to)108433
ISSN1056-8727
DOIs
Publication statusPublished - Apr 2023

Keywords

  • Humans
  • Diabetes Mellitus, Type 2/complications
  • Kidney
  • Albuminuria/complications
  • Renal Insufficiency, Chronic/complications
  • Diabetic Retinopathy/etiology
  • Glomerular Filtration Rate
  • Diabetic Nephropathies
  • Type 2 diabetes
  • Diabetic retinopathy
  • Cardiovascular disease
  • Chronic kidney disease
  • Albuminuria
  • Risk stratification

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