Prevalence of diabetic nephropathy and subsequent cardiovascular outcomes: a nationwide study of 74,014 patients with type 2 diabetes

Abstract Background Nonsteroidal, selective mineralocorticoid receptor antagonists (MRAs) have been shown to reduce cardiovascular events among patients with diabetic nephropathy, a clinical syndrome characterized by persistent albuminuria. However, prior reports suggested substantial underuse of MRAs eligible patients. In real-life, it is unknown how many urinary excretion albumin measured, and the outcomes type 2 diabetes (T2D) versus without albuminuria relatively unknown. Purpose To identify candidates for treatment compare risk in real-life T2D Methods Using Danish nationwide registers, we identified all ≥18 years old prevalent at index date 1st January 2015 an albumin-creatinine ratio (ACR) creatinine level measured within 365 days date. For each patient, last ACR estimated glomerular filtration rate (eGFR) registered were used. eGFR was calculated using CKD-EPI formula. The separated into two groups consisting ≥30 mg/g (albuminuria) or ACR<30 (no albuminuria), respectively. Outcomes both analyzed as time-to-event composite outcome heart failure (HF), myocardial infarction (MI), stroke, all-cause death component endpoint individually. groups, 4-year absolute experiencing HF, MI, stroke. Results A total 158,904 those 74,014 (47%) had year. Of who 29,581 (40%) no 28.6% (95% confidence interval (CI): 28.1–29.1) 18.7% CI: 18.4–19.1), individual components HF 7.0% 6.7–7.3), MI 4.4% 4.2–4.6), stroke 7.6% 7.3–7.9) albuminuria, 4.0% 3.8–4.2), 3.2% 3.1–3.4), 5.5% 5.3–5.7) Conclusion Denmark, only 47% year indicating lack adherence national guidelines. 40% based on trial inclusion criteria, event significant. still displayed death. Our analyses may implications implementation new T2D. Funding Acknowledgement Type funding sources: None.