Gender, Albuminuria and Chronic Kidney Disease Progression in Treated Diabetic Kidney Disease
Abstract
:1. Introduction
2. Patients and Methods
Statistical Analysis
3. Results
3.1. Clinical and Analytical Characteristics of Men and Women
3.2. GFR Loss in Men and Women
3.3. Predictive Value of Baseline UACR for Rapid Progression
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Total (n = 261) | Men (n = 170) | Women (n = 91) | p |
---|---|---|---|---|
Age (years) | 68 ± 13 | 68 ± 12 | 70 ± 13 | 0.13 |
Ethnicity, n (%) | ||||
Caucasian | 243 (93.1) | 156 (91.7) | 87 (95.0) | 0.84 |
Black | 9 (3.4) | 6 (3.5) | 3 (3.3) | |
Asiatic | 9 (3.4) | 8 (4.5) | 1 (1.1) | |
Serum creatinine (mg/dL) | 1.50 ± 0.80 | 1.58 ± 0.83 | 1.36 ± 0.71 | 0.003 |
eGFR CKD-EPI (mL/min/1.73 m2) | 54.8 ± 25.8 | 56.3 ± 25.7 | 52.0 ± 25.8 | 0.20 |
Urinary creatinine (mg/24h) | 1120 ± 398 | 1253 ± 395 | 858 ± 245 | <0.0001 |
Albuminuria (mg/24 h) | 182 [41–515] | 247 [60–645] | 87 [12–275.1] | 0.0002 |
UACR (mg/g) | 156 [37–499] | 187 [50–592] | 99.5 [15–403] | 0.013 |
HbA1C (%) | 7.6 ± 1.36 | 7.63 ± 1.32 | 7.57 ± 1.4 | 0.71 |
Diabetes complications, n (%) | ||||
Diabetic retinopathy | 127/261 (49.7) | 81/170 (47.6) | 46/91 (50.5) | 0.19 |
Mild/moderate/non-proliferative | 72/261 (27.6) | 50/170 (29.4) | 22/91 (24.2) | |
Severe of proliferative | 33/261 (12.6) | 16/170 (9.4) | 17/91 (18.7) | |
Macular edema | 22/261 (8.4) | 15/170 (8.9) | 7/91 (7.7) | |
Diabetic polyneuropathy | 34/261 (13.0) | 22/170 (12.9) | 12/91 (13.2) | 1 |
Cardiovascular disease, n (%) | 128/261 (49.0) | 83/170 (48.8) | 45/91 (49.5) | 1 |
Heart failure | 42/261 (16.1) | 31/170 (18.2) | 11/91 (12.0) | 0.26 |
Acute coronary syndrome | 61/261 (23.4) | 42/170 (24.7) | 19/91 (20.9) | 0.58 |
Stroke | 16/261 (6.1) | 8/170 (4.7) | 8/91 (8.8) | 0.29 |
Peripheral vascular disease | 62/261 (23.8) | 48/170 (28.2) | 14/91 (15.4) | 0.03 |
Arrhythmia | 38/261 (14.6) | 20/170 (11.8) | 18/91 (19.8) | 0.11 |
Tobacco use, n (%) | ||||
Non-smoker | 108/261 (41.4) | 37/170 (21.9) | 71/91 (78.0) | <0.001 |
Smoker | 49/261 (18.8) | 39/170 (23.1) | 10/91 (11.0) | |
Ex-smoker | 103/261 (39.5) | 93/170 (55.0) | 10/91 (11.0) | |
Hypertension, n (%) | 251/261 (96.2) | 165/170 (97.1) | 86/91 (94.5) | 0.19 |
Dyslipidemia, n (%) | 232/261 (88.9) | 149/170 (87.7) | 83/91 (91.5) | 0.62 |
SBP (mmHg) | 137.7 ± 17.8 | 136.8 ± 15.8 | 139.5 ± 21.1 | 0.29 |
DBP (mmHg) | 73.5 ± 12.6 | 74.6 ± 13.1 | 71.6 ± 10.8 | 0.052 |
BMI (kg/m²) (n = 260) | 30.2 ± 5.3 | 29.5 ± 5 | 31.3 ± 5.7 | 0.0073 |
Waist circumference (cm) (n = 180) | 107 ± 13 | 108 ± 13 | 103 ± 12 | 0.046 |
Men | Adjusted Models | ||
OR | 95% CI | p | |
eGFR CKD-EPI (ml/min/1.73 m2) | 1.024 | (1.005–1.044) | 0.011 |
Alkaline phosphatase (UI/mL) | 1.017 | (1.003–1.031) | 0.016 |
Triglycerides (mg/dL) | 1.007 | (1.001–1.013) | 0.019 |
Vitamin B12 (pg/mL) | 1.003 | (1.000–1.006) | 0.024 |
Albumin (g/dl) | 0.196 | (0.051–0.710) | 0.013 |
Diuresis (ml/24h) | 0.999 | (0.998–1.000) | 0.026 |
Waist circumference (cm) | 0.944 | (0.900–0.986) | 0.008 |
BMI (kg/m²) | 0.907 | (0.821–0.991) | 0.03 |
FECa (%) | 0.364 | (0.128–0.860) | 0.019 |
FE phosphate (%) | 0.891 | (0.818–0.958) | 0.001 |
25 OH Vitamin D (ng/mL) | 0.941 | (0.888–0.991) | 0.021 |
UACR (mg/g) | 1.001 | (1.001–1.002) | 0.000 |
Women | Adjusted models | ||
OR | 95% CI | p | |
Leucocytes (n/µL) | 1.000 | (1.000–1.001) | 0.032 |
Age (years) | 1.085 | (1.012–1.185) | 0.019 |
hsCRP (mg/dL) | 3.806 | (1.368–22.177) | 0.004 |
SBP (mmHg) | 1.040 | (1.007–1.081) | 0.016 |
Heart rate (bpm) | 1.067 | (1.002–1.144) | 0.044 |
Folic acid (pg/mL) | 0.712 | (0.520–0.893) | 0.001 |
FE potassium (%) | 0.782 | (1.099–1.563) | 0.001 |
FE magnesium (%) | 0.661 | (0.420–0.966) | 0.031 |
25 OH Vitamin D (ng/mL) | 0.886 | (0.782–0.970) | 0.006 |
UACR (mg/g) | 1.001 | (1.000–1.002) | 0.008 |
Total Population | ||||
Variable | Coef. | OR | 95% CI | p |
UACR (mg/g) | 0.002 | 1.002 | (1.001–1.003) | 0.000 |
FE phosphate (%) | −0.111 | 0.895 | (0.841–0.944) | 0.000 |
Triglycerides (mg/dL) | 0.006 | 1.006 | (1.002–1.011) | 0.006 |
Uric acid (mg/dL) | 0.327 | 1.387 | (1.080–1.800) | 0.010 |
Vitamin B12 (pg/mL) | 0.003 | 1.003 | (1.001–1.006) | 0.001 |
Constant | −4.561 | |||
Men | ||||
Variable | Coef. | OR | 95% CI | p |
UACR (mg/g) | 0.002 | 1.002 | (1.001–1.004) | <0.001 |
FE phosphates (%) | −0.184 | 0.832 | (0.719–0.920) | <0.001 |
Waist circumference (cm) | −0.082 | 0.921 | (0.848–0.986) | 0.015 |
Vitamin B12 (pg/mL) | 0.006 | 1.006 | (1.002–1.011) | 0.005 |
Mean corpuscular volume (fl) | 0.210 | 1.234 | (1.032–1.582) | 0.018 |
DDLV (mm) | 0.120 | 1.127 | (1.001–1.291) | 0.047 |
Constant | −17.44 | |||
Women | ||||
Variable | Coef. | OR | 95% CI | p |
Folic acid (pg/mL) | −0.250 | 0.779 | (0.555–0.978) | 0.029 |
SBP (mmHg) | 0.075 | 1.078 | (1.029–1.150) | <0.001 |
FE Mg (%) | −0.447 | 0.639 | (0.391–0.939) | 0.020 |
Uric acid (mg/dL) | 0.620 | 1.859 | (1.103–3.503) | 0.019 |
Constant | −12.91 |
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Fernandez-Fernandez, B.; Mahillo, I.; Sanchez-Rodriguez, J.; Carriazo, S.; Sanz, A.B.; Sanchez-Niño, M.D.; Ortiz, A. Gender, Albuminuria and Chronic Kidney Disease Progression in Treated Diabetic Kidney Disease. J. Clin. Med. 2020, 9, 1611. https://doi.org/10.3390/jcm9061611
Fernandez-Fernandez B, Mahillo I, Sanchez-Rodriguez J, Carriazo S, Sanz AB, Sanchez-Niño MD, Ortiz A. Gender, Albuminuria and Chronic Kidney Disease Progression in Treated Diabetic Kidney Disease. Journal of Clinical Medicine. 2020; 9(6):1611. https://doi.org/10.3390/jcm9061611
Chicago/Turabian StyleFernandez-Fernandez, Beatriz, Ignacio Mahillo, Jinny Sanchez-Rodriguez, Sol Carriazo, Ana B. Sanz, Maria Dolores Sanchez-Niño, and Alberto Ortiz. 2020. "Gender, Albuminuria and Chronic Kidney Disease Progression in Treated Diabetic Kidney Disease" Journal of Clinical Medicine 9, no. 6: 1611. https://doi.org/10.3390/jcm9061611