Open AccessAssociation of renal arteriosclerosis and hypertension with renal and cardiovascular outcomes in Japanese type 2 diabetes patients with diabetic nephropathy
Author(s) -
Shimizu Miho,
Furuichi Kengo,
Toyama Tadashi,
Funamoto Tomoaki,
Kitajima Shinji,
Hara Akinori,
Iwata Yasunori,
Sakai Norihiko,
Takamura Toshinari,
Kitagawa Kiyoki,
Yoshimura Mitsuhiro,
Kaneko Shuichi,
Yokoyama Hitoshi,
Wada Takashi
Publication year - 2019
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12981
Subject(s) - medicine , hazard ratio , diabetes mellitus , renal function , diabetic nephropathy , blood pressure , myocardial infarction , stroke (engine) , cardiology , nephropathy , type 2 diabetes , kidney disease , arteriosclerosis , confidence interval , kidney , endocrinology , mechanical engineering , engineering
Aims/Introduction The present retrospective study investigated the impact of renal arteriosclerosis ( AS ) and hypertension ( HT ) on long‐term renal and cardiovascular outcomes in Japanese type 2 diabetes patients with biopsy‐proven diabetic nephropathy. Materials and Methods A total of 185 patients were enrolled. Patients were divided into four groups stratified by renal AS status and the presence of HT . The outcomes for this study were the first occurrence of renal events (a need for dialysis or a 30% decline in estimated glomerular filtration rate from baseline) and cardiovascular events (cardiovascular death, non‐fatal myocardial infarction, coronary intervention or non‐fatal stroke). Results The proportion of renal AS scores ≥1 was 88.3% among patients with normal‐range blood pressure ( BP ) and 95.4% among patients with HT. During a mean follow‐up period of 7.6 years, 129 episodes of renal composite events and 55 episodes of cardiovascular events were observed. Compared with patients with no renal AS and normal‐range BP , a renal AS score ≥1 increased the risk of renal composite events with a multivariable‐adjusted hazard ratio of 3.21 (95% confidence interval [95% CI] 1.27–8.14) in patients with normal‐range BP and 4.99 (95% CI 1.98–12.54) in patients with HT , whereas renal AS score ≥1 increased the risk of cardiovascular events with a multivariable‐adjusted hazard ratio of 6.06 (95% CI 1.24–29.61) in patients with normal‐range BP and 10.02 (95% CI 1.92–52.39) in patients with HT . Conclusions Renal AS was associated with increasing risks for renal composite events and cardiovascular events in both normal‐range BP and HT . The risks of renal composite events and cardiovascular events were the highest in both renal AS and HT .