International variability of renal and cardiovascular outcomes and mortality in patients with type 2 diabetes mellitus in Europe

Thöni, S. et al. (2023) International variability of renal and cardiovascular outcomes and mortality in patients with type 2 diabetes mellitus in Europe. Kidney and Blood Pressure Research, 48(1), pp. 165-174. (doi: 10.1159/000528438) (PMID:37015210) (PMCID:PMC10077442)

Abstract

Introduction: Type 2 diabetes and its complications represent a huge burden to public health. With this prospective, observational cohort study, we aimed to estimate and to compare the incidence rate (IR) of renal and cardiovascular outcomes and all-cause mortality in patients with type 2 diabetes in different European countries. Methods: The renal endpoint was a composite of a sustained decline in estimated GFR of at least 40%, a sustained increase in albuminuria of at least 30% including a transition in albuminuria class, progression to kidney failure with replacement therapy, or death from renal causes. The cardiovascular endpoint was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Results: 3,131 participants from four European countries (Austria, Hungary, The Netherlands, and Scotland) with a median follow-up time of 4.4 years were included. IRs were adjusted for several risk factors including sex, age, estimated GFR, albuminuria, HbA1c, blood pressure, and duration of type 2 diabetes. Across countries, the adjusted IR for the renal endpoint was significantly higher in Hungary and Austria, and the adjusted IR for the cardiovascular endpoint was significantly higher in Scotland and Austria. All-cause mortality was significantly higher in Scotland compared to all other countries. Conclusion: Our findings show how the longitudinal outcome of patients with type 2 diabetes varies significantly across European countries even after accounting for the distribution of underlying risk factors.

• Item Type: Articles
• Additional Information: This study was supported by the project DC-ren that has received funding from the European Union’s Horizon 2020 research and innovation program (Grant No. 848011, 2020) and by the Innovative Medicines Initiative 2 Joint Undertaking (Grant No. 115974, 2015). This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mark, Professor Patrick
• Authors: Thöni, S., Keller, F., Denicolò, S., Eder, S., Buchwinkler, L., Rosivall, L., Wiecek, A., Mark, P. B., Rossing, P., Heerspink, H. L., and Mayer, G.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Kidney and Blood Pressure Research
• Publisher: Karger Publishers
• ISSN: 1420-4096
• ISSN (Online): 1423-0143
• Published Online: 04 April 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Kidney and Blood Pressure Research 48(1): 165-174
• Publisher Policy: Reproduced under a Creative Commons License