Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function
- Author:
Da Hea SEO
1
;
So Hun KIM
;
Joon Ho SONG
;
Seongbin HONG
;
Young Ju SUH
;
Seong Hee AHN
;
Jeong Taek WOO
;
Sei Hyun BAIK
;
Yongsoo PARK
;
Kwan Woo LEE
;
Young Seol KIM
;
Moonsuk NAM
;
Author Information
- Publication Type:Multicenter Study
- Keywords: Carotid stenosis; Diabetes mellitus, type 2; Diabetic nephropathies
- MeSH: Carotid Artery Diseases; Carotid Intima-Media Thickness; Carotid Stenosis; Cohort Studies; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Discrimination (Psychology); Follow-Up Studies; Glomerular Filtration Rate; Humans; Logistic Models; Prospective Studies; Risk Factors; ROC Curve
- From:Diabetes & Metabolism Journal 2019;43(6):840-853
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Recent evidences indicate that early rapid renal function decline is closely associated with the development and progression of diabetic kidney disease. We have investigated the association between carotid atherosclerosis and rapid renal function decline in patients with type 2 diabetes mellitus and preserved renal function.METHODS: In a prospective, multicenter cohort, a total of 967 patients with type 2 diabetes mellitus and preserved renal function were followed for 6 years with serial estimated glomerular filtration rate (eGFR) measurements. Common carotid intima-media thickness (CIMT) and presence of carotid plaque were assessed at baseline. Rapid renal function decline was defined as an eGFR decline >3.3% per year.RESULTS: Over a median follow-up of 6 years, 158 participants (16.3%) developed rapid renal function decline. While there was no difference in CIMT, the presence of carotid plaque in rapid decliners was significantly higher than in non-decliners (23.2% vs. 12.2%, P<0.001). In multivariable logistic regression analysis, presence of carotid plaque was an independent predictor of rapid renal function decline (odds ratio, 2.33; 95% confidence interval, 1.48 to 3.68; P<0.0001) after adjustment for established risk factors. The model including the carotid plaque had better performance for discrimination of rapid renal function decline than the model without carotid plaque (area under the receiver operating characteristic curve 0.772 vs. 0.744, P=0.016).CONCLUSION: Close monitoring of renal function and early intensive management may be beneficial in patients with type 2 diabetes mellitus and carotid plaques.
