Novel kidney disease index predicts cardiovascular and kidney outcomes in type 2 diabetes: Study

Canada: The albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) are the risk factors for diabetes-related outcomes. A composite that combines information from both may provide a simple way of risk assessment.

Considering the above, Hertzel C. Gerstein, and colleagues in a recent study in Cardiovascular Diabetology have described a novel kidney disease index (KDI) that reflects both eGFR and ACR and predicted kidney and cardiovascular outcomes in type 2 diabetes. The researchers explained, "KDI combines the baseline ACR and eGFR into a novel composite risk factor that has a simple linear relationship with incident serious outcomes in patients with diabetes and additional CV risk factors. 

In the post hoc epidemiologic analysis, the researchers included 9115 of 9901 Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) participants with both an ACR and eGFR at baseline. They estimated the hazard of higher baseline levels of 1/eGFR and natural log-transformed ACR and their interaction for incident kidney outcomes, major adverse cardiovascular events (MACE), and deaths. They also assessed the hazard of the geometric mean of these two baseline measures (the kidney disease index or KDI).