Renal function deterioration among diabetes patients strongly linked to HF hospitalization

FRANCE: Beyond baseline eGFR, renal function deterioration was a major and independent risk factor linked to the development of heart failure hospitalization (HFH) in people with type 2 diabetes, states a study published in the journal, Diabetes Research and Clinical Practice.

Globally, the prevalence of diabetes is rising, and by 2030, more than 10% of people will have the disease. A recent large meta-analysis involving over 12 million people showed that those with diabetes have twice as high chance of developing heart failure than people without it. Additionally, a recent revelation showed that among those with type 2 diabetes, the incidence of heart failure hospitalization (HFH) is comparable to that of myocardial infarction.

The researchers of this study evaluated the relationship between heart failure hospitalization (HFH) and renal function deterioration in people with type 2 diabetes and established dynamic HFH predictions (DynHFH) based on repeated estimated glomerular filtration rate (eGFR) data.

1413 patients from the SURDIAGENE cohort were investigated. From 2002 to 2012, participants were registered at the University Hospital of Poitiers (France). The criteria for inclusion, included having type 2 diabetes without end-stage kidney disease (ESKD), which is indicated by the requirement for ongoing renal replacement treatment and/or an eGFR below 15 ml/min/1.73 m2. They determined the likelihood of remaining HFH-free in the following five years using a joint model for longitudinal CKD-EPI measurements and HFH risk.

Key findings of the study:

• The average annual reduction in eGFR was calculated to be 1.48 ml/min/1.73 m2 (95% confidence interval: 1.23 to 1.74).
• Independent of 7 baseline factors (from clinical, biological and ECG domains), eGFR decline was consistently related with the risk of HFH (adjHR = 1.15 for an increase in yearly decline of 1 ml/min/1.73m2, 95% CI from 1.03 to 1.26).
• AUC at 0.87 (95%CI from 0.84 to 0.91) at patient enrollment and 0.77 (95%CI from 0.67 to 0.87) after seven years' follow-up indicate effective discrimination along the prediction times.

The DynHFH, a tool that dynamically predicts HFH in people with type 2 diabetes, may be useful for precision medicine and the application of stratified medical decision-making in the age of computer-assisted medical decision-making, lead author, Etienne Dantan, Nantes University and team stated.

"We saw favorable prognostic results from the prospective observational SURDIAGENE cohort," they concluded.

REFERENCE

Etienne Dantan, Maxime Pailler, Stéphanie Ragot, Elise Gand, Jean-Noel Trochu, Bertrand Cariou, Pierre-Jean Saulnier, Samy Hadjadj investigator,Renal function decline and heart failure hospitalisation in patients with type 2 diabetes: dynamic predictions from the prospective SURDIAGENE cohort, Diabetes Research and Clinical Practice,2022,110152,ISSN 0168-8227,https://doi.org/10.1016/j.diabres.2022.110152