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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Red cell distribution width (RDW), platelet distribution width (PDW), serum albumin (ALB), and hemoglobin (Hb) are routinely measured laboratory markers that reflect hematologic and nutritional status. Although each has been individually associated with adverse outcomes in patients with diabetes, their combined prognostic value remains unclear. We aimed to develop a novel composite score integrating these parameters and evaluate its predictive ability for kidney outcomes in patients with type 2 diabetes mellitus (T2DM).
We analyzed 1,014 patients with T2DM enrolled in the Fukushima CKD Cohort Study. A new composite score, the Kidney RDW–ALB–PDW–Hb (K-RAPH) score, was constructed using standardized Z-scores of four biomarkers as follows: K-RAPH = ZRDW + ZPDW – ZALB – ZHb. Participants were divided into quartiles according to the K-RAPH score. The primary endpoint was kidney events, defined as a composite of end-stage kidney disease requiring kidney replacement therapy or a ≥50% decline in estimated glomerular filtration rate (eGFR) from baseline. All-cause mortality and new-onset cardiovascular events were assessed as secondary endpoints. Survival analyses were performed using Kaplan–Meier curves and Cox proportional hazards models adjusted for age, sex, smoking history, history of cardiovascular disease, body mass index, systolic blood pressure, baseline eGFR, hemoglobin A1c, and proteinuria. Discriminative performance was evaluated by the area under the receiver operating characteristic curve (AUC).
The median age was 66 years (interquartile range [IQR], 59–74), median eGFR was 67.9 mL/min/1.73 m² (IQR, 53.1–80.9), and median hemoglobin A1c was 6.8% (IQR, 6.3–7.4). Males accounted for 57.5% of the cohort, and 16.1% had a history of cardiovascular disease. Patients were stratified into quartiles according to the K-RAPH score. Those in higher quartiles were older and had a higher proportion of females, lower body mass index, and lower eGFR. During a median follow-up of 5.3 years, 95 kidney events, 82 deaths, and 118 cardiovascular events occurred. Kaplan–Meier analysis revealed significantly higher incidences of kidney events (P < 0.001), all-cause mortality (P < 0.001), and cardiovascular events (P < 0.001) in higher K-RAPH quartiles compared with lower quartiles. In multivariable Cox models, compared with the lowest quartile (Q1), patients in the highest quartile (Q4) had a significantly increased risk of kidney events (hazard ratio [HR], 14.3; 95% confidence interval [CI], 4.89–41.6). Similar trends were observed for all-cause mortality and cardiovascular events. The AUCs of the K-RAPH score were 0.813 (95% CI, 0.766–0.860) for kidney events, 0.728 (95% CI, 0.664–0.791) for all-cause mortality, and 0.648 (95% CI, 0.597–0.700) for cardiovascular events.
The K-RAPH score, a simple composite index constructed using Z-scores of four routinely available biomarkers, effectively predicts adverse outcomes — particularly kidney events — in patients with T2DM. This cos
