Risk factors for kidney disorders in patients with type 2 diabetes at high cardiovascular risk: An exploratory analysis (DEVOTE 12)
Author(s)
Type
Journal Article
Abstract
AIM: To investigate risk factors associated with kidney disorders in patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk. METHODS: In DEVOTE, a cardiovascular outcomes trial, 7637 patients were randomised to insulin degludec (degludec) or insulin glargine 100 units/mL (glargine U100), with standard of care. In these exploratory post hoc analyses, serious adverse event reports were searched using Standardised MedDRA® Queries related to chronic kidney disease (CKD) or acute kidney injury (AKI). Baseline predictors of CKD, AKI and change in estimated glomerular filtration rate (eGFR) were identified using stepwise selection and Cox or linear regression. RESULTS: Over 2 years, eGFR (mL/min/1.73 m2) decline was small and similar between treatments (degludec: 2.70; glargine U100: 2.92). Overall, 97 and 208 patients experienced CKD and AKI events, respectively. A history of heart failure was a risk factor for CKD (hazard ratio [HR] 1.97 [95% confidence interval [CI] 1.41; 2.75]) and AKI (HR 2.28 [95% CI 1.64; 3.17]). A history of hepatic impairment was a significant predictor of CKD (HR 3.28 [95% CI 2.12; 5.07]) and change in eGFR (estimate: -8.59 [95% CI -10.20; -7.00]). CONCLUSION: Our findings indicate that traditional, non-modifiable risk factors for kidney disorders apply to insulin-treated patients with T2D at high CV risk. TRIAL REGISTRATION: NCT01959529 (ClinicalTrials.gov).
Date Issued
2020-11-01
Date Acceptance
2020-11-01
Citation
Diabetes and Vascular Disease Research, 2020, 17 (6)
ISSN
1479-1641
Publisher
SAGE Publications
Journal / Book Title
Diabetes and Vascular Disease Research
Volume
17
Issue
6
Copyright Statement
© The Author(s) 2020. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33280425
Subjects
CVOT
Cardiovascular
chronic renal failure
diabetic kidney disease
insulin analogues
type 2 diabetes mellitus
Acute Kidney Injury
Diabetes Mellitus, Type 2
Double-Blind Method
Female
Glomerular Filtration Rate
Heart Disease Risk Factors
Humans
Hypoglycemic Agents
Insulin Glargine
Insulin, Long-Acting
Kidney
Male
Middle Aged
Renal Insufficiency, Chronic
Risk Assessment
Time Factors
Treatment Outcome
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2020-12-06