The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus
A urine albumin/creatinine ratio (UACR) <30 mg/g is considered to be normal, while increased risk of incident hypertension and cardiovascular disease mortality in subjects with high normal UACR level had been observed. However, a mild elevated but normal UACR level was associated with the ris...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.858267/full |
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| author | Wei-Hua Tang Wei-Hua Tang Wei-Chin Hung Wei-Chin Hung Chao-Ping Wang Chao-Ping Wang Cheng-Ching Wu Cheng-Ching Wu Chin-Feng Hsuan Chin-Feng Hsuan Chin-Feng Hsuan Teng-Hung Yu Teng-Hung Yu Chia-Chang Hsu Chia-Chang Hsu Ya-Ai Cheng Fu-Mei Chung Yau-Jiunn Lee Yung-Chuan Lu Yung-Chuan Lu |
| author_facet | Wei-Hua Tang Wei-Hua Tang Wei-Chin Hung Wei-Chin Hung Chao-Ping Wang Chao-Ping Wang Cheng-Ching Wu Cheng-Ching Wu Chin-Feng Hsuan Chin-Feng Hsuan Chin-Feng Hsuan Teng-Hung Yu Teng-Hung Yu Chia-Chang Hsu Chia-Chang Hsu Ya-Ai Cheng Fu-Mei Chung Yau-Jiunn Lee Yung-Chuan Lu Yung-Chuan Lu |
| author_sort | Wei-Hua Tang |
| collection | DOAJ |
| description | A urine albumin/creatinine ratio (UACR) <30 mg/g is considered to be normal, while increased risk of incident hypertension and cardiovascular disease mortality in subjects with high normal UACR level had been observed. However, a mild elevated but normal UACR level was associated with the risk of initiating chronic kidney disease (CKD) is uncertain. We investigated whether higher normal UACR is associated with the risk of developing CKD. A total of 4821 subjects with type 2 diabetes mellitus (T2DM), an estimated glomerular filtration rate >60 ml/min/1.73 m2 and UACR <30 mg/g enrolled in a diabetes disease management program between 2006 and 2020 were studied. The optimal cutoff point for baseline UACR as a predictor for progression to CKD according to the 2012 KDIGO definition was calculated using receiving operating characteristic curve analysis. After a mean of 4.9 years follow-up, the CKD risk progression increased in parallel with the quartiles of baseline UACR <30 mg/g (p for trend <0.0001). UACR cutoff points of 8.44 mg/g overall, 10.59 mg/g in males and 8.15 mg/g in females were associated with the risk of CKD progression. In multivariate Cox regression analysis, the hazard ratios for the association between UACR (>8.44 mg/g, >10.9 mg/g, >8.15 mg/g in overall, male, and female patients, respectively) and the risk of CKD progression were significant. This study demonstrated that a cutoff UACR value of >10 mg/g could significantly predict the cumulative incidence and progression of CKD in patients with T2DM. |
| first_indexed | 2024-12-12T04:58:20Z |
| format | Article |
| id | doaj.art-27a1cf20d9d34887905bc03e1ec83ce5 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-12T04:58:20Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-27a1cf20d9d34887905bc03e1ec83ce52022-12-22T00:37:17ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-06-011310.3389/fendo.2022.858267858267The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes MellitusWei-Hua Tang0Wei-Hua Tang1Wei-Chin Hung2Wei-Chin Hung3Chao-Ping Wang4Chao-Ping Wang5Cheng-Ching Wu6Cheng-Ching Wu7Chin-Feng Hsuan8Chin-Feng Hsuan9Chin-Feng Hsuan10Teng-Hung Yu11Teng-Hung Yu12Chia-Chang Hsu13Chia-Chang Hsu14Ya-Ai Cheng15Fu-Mei Chung16Yau-Jiunn Lee17Yung-Chuan Lu18Yung-Chuan Lu19Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Dachang Hospital, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanSchool of Medicine, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanThe School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, TaiwanDepartment of Health Care Administration, College of Medicine, I-Shou University, Kaohsiung, TaiwanDivision of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan0Lee’s Endocrinologic Clinic, Pingtung, TaiwanSchool of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan1Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, Kaohsiung, TaiwanA urine albumin/creatinine ratio (UACR) <30 mg/g is considered to be normal, while increased risk of incident hypertension and cardiovascular disease mortality in subjects with high normal UACR level had been observed. However, a mild elevated but normal UACR level was associated with the risk of initiating chronic kidney disease (CKD) is uncertain. We investigated whether higher normal UACR is associated with the risk of developing CKD. A total of 4821 subjects with type 2 diabetes mellitus (T2DM), an estimated glomerular filtration rate >60 ml/min/1.73 m2 and UACR <30 mg/g enrolled in a diabetes disease management program between 2006 and 2020 were studied. The optimal cutoff point for baseline UACR as a predictor for progression to CKD according to the 2012 KDIGO definition was calculated using receiving operating characteristic curve analysis. After a mean of 4.9 years follow-up, the CKD risk progression increased in parallel with the quartiles of baseline UACR <30 mg/g (p for trend <0.0001). UACR cutoff points of 8.44 mg/g overall, 10.59 mg/g in males and 8.15 mg/g in females were associated with the risk of CKD progression. In multivariate Cox regression analysis, the hazard ratios for the association between UACR (>8.44 mg/g, >10.9 mg/g, >8.15 mg/g in overall, male, and female patients, respectively) and the risk of CKD progression were significant. This study demonstrated that a cutoff UACR value of >10 mg/g could significantly predict the cumulative incidence and progression of CKD in patients with T2DM.https://www.frontiersin.org/articles/10.3389/fendo.2022.858267/fullType 2 diabetes mellituslow-grade albuminuriariskchronic kidney diseaseprogression |
| spellingShingle | Wei-Hua Tang Wei-Hua Tang Wei-Chin Hung Wei-Chin Hung Chao-Ping Wang Chao-Ping Wang Cheng-Ching Wu Cheng-Ching Wu Chin-Feng Hsuan Chin-Feng Hsuan Chin-Feng Hsuan Teng-Hung Yu Teng-Hung Yu Chia-Chang Hsu Chia-Chang Hsu Ya-Ai Cheng Fu-Mei Chung Yau-Jiunn Lee Yung-Chuan Lu Yung-Chuan Lu The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus Frontiers in Endocrinology Type 2 diabetes mellitus low-grade albuminuria risk chronic kidney disease progression |
| title | The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus |
| title_full | The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus |
| title_fullStr | The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus |
| title_full_unstemmed | The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus |
| title_short | The Lower Limit of Reference of Urinary Albumin/Creatinine Ratio and the Risk of Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Mellitus |
| title_sort | lower limit of reference of urinary albumin creatinine ratio and the risk of chronic kidney disease progression in patients with type 2 diabetes mellitus |
| topic | Type 2 diabetes mellitus low-grade albuminuria risk chronic kidney disease progression |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.858267/full |
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