INCREASED RISK OF HF AND RETINOPATHY WITH ADVANCED CKD BUT NOT WITH ASCVD IN PATIENTS WITH T2D (CITE 2 STUDY)

Introduction:

Chronic kidney disease (CKD) in type 2 diabetes (T2D) is considered an independent risk factor for atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), peripheral neuropathy (DPN), and retinopathy. The FIELD study documented albuminuric CKD as an independent risk factor for ASCVD in patients with T2D, although on a multivariate analysis nearly 80% of the association was explained by elevated blood pressure and a low high-density cholesterol. The CKD in Indian T2D patient evaluation (CITE) initiative was undertaken to assess the relationship between CKD and co-morbidities associated with T2D.

Methods:

A multi-centre, cross sectional, prospective study was conducted to assess the relationship between co-morbidities associated with T2D with CKD. Three distinct patterns of CKD were included for the analysis (CKD A: eGFR <60 ml/min without albuminuria, CKD B: albuminuria with eGFR>=60 ml/min, and CKD C: eGFR <60 ml/min and albuminuria). A descriptive and analytical multivariate logistic regression analysis was undertaken to assess the odds of T2D related complications in patients with established CKD.

Results:

Of the 1,802 T2D with CKD patients screened, 1,153 patient-related data were eligible for analysis. DATAtab: Online Statistics Calculator and Minitab statistical software 21 was used to conduct the analysis. In patients with T2D and CKD, 20% had ASCVD & DPN, 17% retinopathy, and 5% HF. (Figure 1) Multivariate logistic regression analysis indicated increased odds of heart failure (multivariate odds ratio 2.02, 95% CI 1.22-3.35) and retinopathy (multivariate odds ratio 1.98, 95% CI 1.46-2.69) with CKD C. Independently CKD category A and B were not associated with these co-morbidities. However, there was increased odds of retinopathy (multivariate odds ratio 2.7, 95% CI 1.63-4.47) with macroalbuminuria (UACR >300 mg/g). 

Conclusions:

There is an increased odds of heart failure and retinopathy in T2D patients with CKD C. In contrast to previous reports CKD B was associated with increased odds of retinopathy (only in the macroalbuminuric subset) and not ASCVD or HF.

Figure 1: Prevalence of T2D related co-morbidities in the backdrop of CKD.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.