Alternative kidney filtration markers and the risk of major macrovascular and microvascular events, and <scp>all‐cause</scp> mortality in individuals with type 2 diabetes in the <scp>ADVANCE</scp> trial

Kim, Hyun-Ju; Wang, Dan; Chalmers, John; Jun, Min; Zoungas, Sophia; Marre, Michel; Hamet, Pavel; Harrap, Stephen; Mancia, Giuseppe; Poulter, Neil; Cooper, Mark E.; Woodward, Mark; Selvin, Elizabeth; Rebholz, Casey M.

doi:10.1111/1753-0407.13083

Cited by 5 publications

(8 citation statements)

References 40 publications

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“…Where, serum globulin β2-MG is of low molecular weight, has high stability and can be ltered by the glomerular ltration membrane before being absorbed by the proximal convoluted tubule. Increased serum β2-MG levels in T2DM patients frequently signify that the patient's glomerular ltration function is impaired [41]. This is also in accord with Kim et al, and Kamal et al, [42] [43].…”

Section: Discussionsupporting

confidence: 78%

Renoprotective impact of Dapagliflozin and Mulberry extracts toward Fr-STZ induced diabetic nephropathy in rats: Biochemical and Molecular aspects

Gad

Abdel-Rahman

Abd-El-Fattah

et al. 2023

Preprint

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Among the most typical reasons of end-stage renal disease (ESRD) is diabetic nephropathy (DN), which is also rated as a major microvascular complication of diabetes mellitus. The existent study looked at the impact of dapagliflozin, mulberry fruit and leaves extracts and their combination on the kidney of diabetic rats. To induce diabetic nephropathy, experimental rats were supplied with 10% fructose (Fr) in drinking water for the first two weeks. Each Fr-fed animal received an intraperitoneal injection of a low single dose of STZ (40 mg/kg) after being fasted for the whole night. Sixty albino rats were separated into six equivalent groups. Group I control rats, group II untreated diabetic rats, group III–VI are diabetic groups; received dapagliflozin for 4 weeks, mulberry fruit extract, mulberry leaves extract and combination of DAPA, MFE and MLE, respectively for 6 weeks. Untreated diabetic rats exhibited considerable rise in serum glucose, urea, creatinine, KIM-1, β2-MG, TNF-α, and TGβ1 levels compared to control rats, while treated diabetic ones manifested significant decrease in these measures in contrast to the untreated diabetic rats. Also, renal tissue IL-6, NF-κB and NADPH oxidase manifested significant increase in untreated diabetic rats, while treated groups revealed significant decline in comparison to the untreated one. DAPA and mulberry fruit and leaves extracts optimized IL-10 and renin expression in renal tissue. Histopathological picture of kidney, revealed significant improvement in rats received DAPA and mulberry extracts compared to untreated diabetic rats. It could be concluded that, DAPA, mulberry fruits and leaves extracts alleviated diabetic nephropathy complications. Therefore, combining these ingredients in a supplement may be promising for modulating diabetic nephropathy.

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Section: Discussionsupporting

confidence: 78%

Renoprotective impact of Dapagliflozin and Mulberry extracts toward Fr-STZ induced diabetic nephropathy in rats: Biochemical and Molecular aspects

Gad

Abdel-Rahman

Abd-El-Fattah

et al. 2023

Preprint

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“…Compared with nondeclining patients, the result was a statistically significant HR of 2.09 for all causes of death. In the Kim et al study [ 28 ], patients with eGFR slope decline were defined as having a 30% reduction from baseline eGFR. Compared with patients with stable eGFR slope, the HR was 3.26.…”

Section: Resultsmentioning

confidence: 99%

Is eGFR Slope a Novel Predictor of Chronic Complications of Type 2 Diabetes Mellitus? A Systematic Review and Meta-Analysis

Sartore,

Ragazzi,

Deppieri

et al. 2024

Journal of Diabetes Research

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Background. Diabetic kidney disease affects approximately 40% of patients with type 2 diabetes mellitus (T2DM) and is associated with an increased risk of end-stage kidney disease (ESKD) and cardiovascular (CV) events, as well as increased mortality. Among the indicators of decline in renal function, the eGFR slope is acquiring an increasing clinical interest. The aim of this study was to evaluate, through a systematic review of the literature and meta-analysis of the collected data, the association between the decline of the eGFR slope, chronic complications, and mortality of T2DM patients, in order to understand whether or not the eGFR slope can be defined as a predictive indicator of complications in T2DM. Methods. The review and meta-analysis were conducted according to PRISMA guidelines considering published studies on patients with T2DM. A scientific literature search was carried out on PubMed from January 2003 to April 2023 with subsequent selection of scientific papers according to the inclusion criteria. Results. Fifteen studies were selected for meta-analysis. Risk analysis as hazard ratio (HR) indicated a significant association between all events considered (all-cause mortality, CV events, ESKD, and microvascular events) for patients with steeper eGFR slope decline than subjects with stable eGFR. Calculated HRs (with 95% CI) were as follows: for all-cause mortality, 2.31 (1.70-3.15); for CV events, 1.73 (1.43-2.08); for ESKD, 1.54 (1.45-1.64); and for microvascular events, 2.07 (1.57-2.73). Overall HR was 1.82 (1.72-1.92). Conclusions. An association between rapid eGFR decline and chronic diabetes complications was demonstrated, suggesting that eGFR slope variability significantly impacts the course of T2DM and that eGFR slope should be considered as a predictor for chronic complications in patients with T2DM. According to the obtained results, the therapeutic management of the patient with diabetes should not focus exclusively on glycaemic control, and particular attention should be paid to preserve renal function.

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“…However, the number of KFRT events was comparatively small (only 69 events). Another study 18 showed a significant association between serum β2‐MG and new onset or worsening of microvascular disease (i.e. nephropathy and retinopathy).…”

Section: Discussionmentioning

confidence: 97%

“…Another study 18 showed a significant association between serum β2-MG and new onset or worsening of microvascular disease (i.e. nephropathy and retinopathy).…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, the use of serum β2‐MG in combination with serum creatinine is expected to improve the prediction of kidney function. Although the utility of serum β2‐MG has been confirmed in the general population 13 and in patients with chronic kidney disease, 14 the importance of serum β2‐MG on KFRT among patients with diabetes has not been extensively studied 15–18 . The aim of this study was to examine whether the addition of serum β2‐MG to known predictors could improve the prediction performance for incident KFRT among patients with biopsy‐proven DN.…”

Section: Introductionmentioning

confidence: 99%

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Utility of serum β2‐microglobulin for prediction of kidney outcome among patients with biopsy‐proven diabetic nephropathy

Uemura,

Nishimoto,

Eriguchi

et al. 2023

Diabetes Obesity Metabolism

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AimTo examine whether serum β2‐microglobulin (β2‐MG) could improve the prediction performance for kidney failure with replacement therapy (KFRT) among patients with diabetic nephropathy (DN).MethodsPatients with biopsy‐proven DN at Nara Medical University Hospital were included. The exposure of interest was log‐transformed serum β2‐MG levels measured at kidney biopsy. The outcome variable was KFRT. Multivariable Cox regression models and competing‐risk regression models, with all‐cause mortality as a competing event, were performed. Model fit by adding serum β2‐MG levels was calculated using the Akaike information criterion (AIC). The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indexes were used to evaluate the improvement of predictive performance for 5‐year cumulative incidence of KFRT by serum β2‐MG levels.ResultsAmong 408 patients, 99 developed KFRT during a median follow‐up period of 6.7 years. A higher serum β2‐MG level (1‐unit increase in log‐transformed serum β2‐MG level) was associated with a higher incidence of KFRT, even after adjustments for previously known clinical and histological risk factors (hazard ratio [95% confidence interval {CI}]: 3.30 [1.57‐6.94] and subdistribution hazard ratio [95% CI]: 3.07 [1.55‐6.06]). The addition of log‐transformed serum β2‐MG level reduced AIC and improved the prediction of KFRT (NRI and IDI: 0.32 [0.09‐0.54] and 0.03 [0.01‐0.56], respectively).ConclusionsAmong patients with biopsy‐proven DN, serum β2‐MG was an independent predictor of KFRT and improved prediction performance. In addition to serum creatinine, serum β2‐MG should probably be measured for DN.

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Alternative kidney filtration markers and the risk of major macrovascular and microvascular events, and all‐cause mortality in individuals with type 2 diabetes in the ADVANCE trial

Cited by 5 publications

References 40 publications

Renoprotective impact of Dapagliflozin and Mulberry extracts toward Fr-STZ induced diabetic nephropathy in rats: Biochemical and Molecular aspects

Renoprotective impact of Dapagliflozin and Mulberry extracts toward Fr-STZ induced diabetic nephropathy in rats: Biochemical and Molecular aspects

Is eGFR Slope a Novel Predictor of Chronic Complications of Type 2 Diabetes Mellitus? A Systematic Review and Meta-Analysis

Utility of serum β2‐microglobulin for prediction of kidney outcome among patients with biopsy‐proven diabetic nephropathy

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