medwireNews: Study findings published in BMC Medicine show that increasing albuminuria, decreasing estimated glomerular filtration rate (eGFR), and worsening stages of chronic kidney disease (CKD) are independently associated with increased risk for stroke in people with type 2 diabetes.
For the study, Justin Echouffo‑Tcheugui (Johns Hopkins School of Medicine, Baltimore, Maryland, USA) and co-authors included data for 9170 ACCORD trial participants (mean age 62.8 years, 38.2% women) with type 2 diabetes and no history of stroke. During a median follow-up of 4.9 years, 156 individuals experienced a stroke, corresponding to an incidence rate of 3.6 per 1000 person–years.
The researchers found that participants with moderate albuminuria (urine albumin-to-creatinine ratio [UACR] 30 to <300 mg/g) or severe albuminuria (UACR ≥300 mg/g) had a significant 1.61-fold and 2.29-fold higher risk for stroke, respectively, than those with normal albuminuria (UACR <30 mg/g) after adjustment for other stroke risk factors. Although not statistically significant, people with decreased estimated glomerular filtration rate (eGFR; <60 mL/min per 1.73 m2) were 1.50 times more likely to experience a stroke than those with normal eGFR (≥60 mL/min per 1.73 m2).
Higher CKD stages were also linked to increased stroke incidence. Compared with people with no CKD, those in stages G1, G2, and G3 had a significant 1.76-, 1.77-, and 2.03-fold higher risk for stroke, respectively.
The team concludes: “These data support the notion that the prevention of CKD and its progression may help mitigate the risk of stroke in people with type 2 diabetes.”
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