Kidney Week

Abstract: SA-PO173

Large Cross-Sectional Study Revealed the Conditions, Pathogenesis, and Progression of Diabetic Kidney Disease and Early Decliner in Japan

Session Information

• Diabetic Kidney Disease: Clinical - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Yoshida, Yui, the University of Tokyo, Tokyo, Japan

Yui Yoshida,

• Hirakawa, Yosuke, the University of Tokyo, Tokyo, Japan

Yosuke Hirakawa,

• Tanaka, Tetsuhiro, the University of Tokyo, Tokyo, Japan

Tetsuhiro Tanaka,

• Nangaku, Masaomi, the University of Tokyo, Tokyo, Japan

Masaomi Nangaku,

Group or Team Name

• Division of Nephrology and Endocrinology, the University of Tokyo

Background

Estimated glomerular filtration rate (eGFR) decline precedes albuminuria in a certain portion of diabetic patients.
Thus, albuminuria and/or low eGFR in diabetic patients were defined as ‘Diabetic Kidney Disease (DKD)’. In addition, the existence of ‘early decliner’ attracts a lot of attention, whose eGFR declines rapidly from early stage in DKD patients. To understand the prevalence of DKD and the risk factor of early decliner, we integrated several cohorts and cross-sectional data.

Methods

We continue adding up the 14,000 patients data with 9 hospitals, who were diagnosed as diabetes mellitus and did not receive dialysis. Prevalence was calculated based on cross-sectional data in the baseline of each cohort.
We defined DKD as albuminuria ≥ 30 mg/gCr and/or eGFR < 60 ml/min/1.73m². We did 2 types of analysis to look for the risk factors of early decliner, firstly by defined eGFR declined by more than 5 ml/min/1.73m²/year with normal eGFR in the baseline and secondly by trajectory analysis to compare with the provisional standard.

Results

The proportion of DKD was 52% in total with available data. 8.3% patients were categorized as early decliner with the definition of eGFR decline by more than 5 ml/min/1.73m²/year. By trajectory analysis, 21% patients were classified as early decliner whose eGFR decline rate was 4.84 ml/min/1.73m²/year (Image). Two kinds of analyses revealed that the common risk factors with early decliner group were high level of albuminuria and eGFR in the baseline.

Conclusion

The proportion of DKD were over 50% in all diabetic patients in Japan. The mean eGFR decline rate of early decliner by trajectory analysis was 4.84 ml/min/1.73m²/year, similar to provisional standard. The common risk factors of early decliner were high level of albuminuria and eGFR in the baseline status by two types of analyses.

Classification of eGFR trajectories.