Chronic Kidney Disease vs Type 2 Diabetes Mortality Risk in CVD

This article is part of Endocrinology Advisor’s coverage of the American Diabetes Association’s 77th Scientific Sessions (ADA 2017), taking place in San Diego, CA. Our staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back regularly for more news from ADA 2017.

Chronic kidney disease (CKD) increases the risk for mortality in individuals with established cardiovascular disease (CVD). This increased risk potentially may be higher for those with CKD than for those with type 2 diabetes, according to data presented at the American Diabetes Association 77th Scientific Sessions, June 9-13, in San Diego, California.

Researchers from both Austria and the United States evaluated 2108 individuals with CVD (1789 with coronary artery disease confirmed by angiography and 319 with peripheral artery disease confirmed by sonography).

 

Of these, 1248 patients had neither type 2 diabetes nor CKD, 503 had type 2 diabetes but not CKD, 208 did not have type 2 diabetes but had CKD, and 149 had both type 2 diabetes and CKD.

More deaths occurred in the patients with type 2 diabetes than in patients without diabetes (38.2% vs 19.6%; P <.001). Similarly, more patients with CKD with estimated glomerular filtration rates <60 mL/min/1.73 m² died than patients with estimated glomerular filtration rates ≥60 mL/min/1.73 m² (48.8% vs 19.8%; P <.001).

When researchers compared mortality among individuals who had neither condition (16.1%) with mortality in the other groups, they found that mortality was significantly higher in those with type 2 diabetes who did not have CKD (30.5%; P <.001) and in those who had CKD but not type 2 diabetes (40.1%; P <.001). Mortality was highest in those individuals who had both type 2 diabetes and CKD (62.4%; P <.001) compared with those who had type 2 diabetes but not CKD (P <.001) or those without type 2 diabetes but with CKD (P =.045). Finally, patients without type 2 diabetes with CKD had higher mortality rates compared with patients with type 2 diabetes without CKD (P =.013).

“Mortality is extremely high in [patients with CVD] with the combination of CKD and diabetes,” the researchers concluded.

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Reference

Saely CH, Vonbank A, Lins C, et al. Type 2 diabetes, chronic kidney disease, and mortality in patients with established cardiovascular disease. Abstract 6-OR. Presented at: American Diabetes Association (ADA) 77th Scientific Sessions. June 9-13, 2017; San Diego, CA.