Reduction in albuminuria improves outcomes in type 2 diabetes: Study

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-04-01T10:45:35+05:30 | Updated On 1 April 2021 12:01 PM IST

Denmark: A reduction in albuminuria during the 1st year in patients with type 2 diabetes is associated with lesser renal and cardiovascular outcomes, independent of treatment, finds a recent study in the journal Diabetes Care. Although not used to its full potential, monitoring of albuminuria remains an essential part of diabetes care.

Frederik Persson, Steno Diabetes Center Copenhagen, Gentofte, Denmark, and colleagues conducted a post hoc analysis of the LEADER trial to investigate the association between 1-year changes in albuminuria and subsequent risk of cardiovascular and renal events.

LEADER was a randomized trial of liraglutide up to 1.8 mg/day versus placebo added to standard care for 3.5–5 years in 9,340 participants with type 2 diabetes and high cardiovascular risk. The researchers calculated change in urinary albumin-to-creatinine ratio (UACR) from baseline to 1 year in participants with >30% reduction (n = 2,928), 30–0% reduction (n = 1,218), or any increase in UACR (n = 4,124), irrespective of treatment.

Risks of major adverse cardiovascular events (MACE) and a composite nephropathy outcome (from 1 year to end of trial in subgroups by baseline UACR [<30 mg/g, 30–300 mg/g, or ≥300 mg/g]) were assessed using Cox regression. The analysis was adjusted for treatment allocation alone as a fixed factor and for baseline variables associated with cardiovascular and renal outcomes.

Key findings of the study include:

For MACE, hazard ratios (HRs) for those with >30% and 30–0% UACR reduction were 0.82 and 0.99 respectively, compared with any increase in UACR (reference).
For the composite nephropathy outcome, respective HRs were 0.67 and 0.97.
Results were independent of baseline UACR and consistent in both treatment groups.
After adjustment, HRs were significant and consistent in >30% reduction subgroups with baseline micro- or macroalbuminuria.

"A reduction in albuminuria during the 1st year was associated with fewer cardiovascular and renal outcomes, independent of treatment," wrote the authors. "Albuminuria monitoring remains an important part of diabetes care, with great unused potential."

Reference:

The study titled, "Changes in Albuminuria Predict Cardiovascular and Renal Outcomes in Type 2 Diabetes: A Post Hoc Analysis of the LEADER Trial," is published in the journal Diabetes Care.

DOI: https://care.diabetesjournals.org/content/44/4/1020

Diabetes Carealbuminuriatype 2 diabetes

Source : Diabetes Care

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751