1. Risk factors for kidney disorders in patients with type 2 diabetes at high cardiovascular risk: An exploratory analysis (DEVOTE 12)
- Author
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Amod, A, Buse, JB, McGuire, DK, Pieber, TR, Pop-Busui, R, Pratley, RE, Zinman, B, Hansen, MB, Jia, T, Mark, T, Poulter, NR, and DEVOTE Study Group
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,type 2 diabetes mellitus ,Endocrinology, Diabetes and Metabolism ,insulin analogues ,DEVOTE Study Group ,Insulin Glargine ,Type 2 diabetes ,urologic and male genital diseases ,Cardiovascular ,Kidney ,Risk Assessment ,CVOT ,Endocrinology & Metabolism ,Double-Blind Method ,chronic renal failure ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,In patient ,Renal Insufficiency, Chronic ,business.industry ,Type 2 Diabetes Mellitus ,1103 Clinical Sciences ,Exploratory analysis ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,diabetic kidney disease ,Insulin, Long-Acting ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Heart Disease Risk Factors ,1116 Medical Physiology ,Chronic renal failure ,Original Article ,Female ,Kidney disorder ,1115 Pharmacology and Pharmaceutical Sciences ,Cardiology and Cardiovascular Medicine ,business ,Cardiovascular outcomes ,Glomerular Filtration Rate - 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).
- Published
- 2020