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Renal function and ...
Renal function and risk for cardiovascular events in type 2 diabetic patients with hypertension: the RENAAL and LIFE studies
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Eijkelkamp, W. B. (author)
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Zhang, Z. (author)
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Brenner, B. M. (author)
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Cooper, M. E. (author)
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Devereux, R. B. (author)
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- Dahlöf, Björn, 1953 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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Ibsen, H. (author)
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Keane, W. F. (author)
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- Lindholm, Lars H (author)
- Umeå universitet,Allmänmedicin
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Olsen, M. H. (author)
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Parving, H. H. (author)
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Remuzzi, G. (author)
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Shahinfar, S. (author)
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Snapinn, S. M. (author)
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Wachtell, K. (author)
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de Zeeuw, D. (author)
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(creator_code:org_t)
- 2007
- 2007
- English.
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In: J Hypertens. - 0263-6352. ; 25:4, s. 871-6
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http://www.ncbi.nlm....
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https://gup.ub.gu.se...
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Abstract
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- OBJECTIVE: To investigate whether a threshold exists for cardiovascular risk in type 2 diabetic patients with hypertension, the association between renal function and cardiovascular risk was examined across the entire physiological range of serum creatinine. DESIGN AND METHODS: The RENAAL and LIFE studies enrolled 1513 and 1195 patients with type 2 diabetes and hypertension, respectively. The relationship between baseline serum creatinine and the risk for a composite outcome of myocardial infarction, stroke or cardiovascular death was examined using Cox regression models. To adjust for heterogeneity between studies and treatment groups, these factors were included as strata when applicable. The analyses were conducted with adjustment for age, gender, smoking, alcohol use, blood pressure, heart rate, total and high-density lipoprotein (HDL) cholesterol, hemoglobin, albuminuria and prior cardiovascular disease. RESULTS: The hazard ratios across the baseline serum creatinine categories < 0.9 mg/dl, 0.9-1.2 mg/dl, 1.2-1.6 mg/dl, 1.6-2.8 mg/dl and >or= 2.8 mg/dl were 0.51 (95% confidence interval 0.34, 0.74), 0.74 (0.55, 1.00), 1.00 (reference), 1.24 (0.96, 1.59) and 1.67 (1.17, 2.91), respectively. Baseline serum creatinine (per mg/dl) strongly predicted the composite cardiovascular endpoint in LIFE [2.82(1.74,4.56), P < 0.001], RENAAL [1.41(1.12,1.79), P < 0.001], as well as the combined studies [1.51(1.21,1.87), P < 0.001]. CONCLUSION: A progressively higher risk for the composite cardiovascular endpoint was observed with incremental baseline serum creatinine in type 2 diabetic patients with hypertension, even within the normal range. Thus, there appears to be no serum creatinine threshold level for an increased cardiovascular risk. Baseline serum creatinine was a major independent risk factor for cardiovascular disease (www.ClinicalTrials.gov number NCT00308347).
Keyword
- Aged
- Albuminuria/metabolism
- Biological Markers/blood/urine
- Blood Pressure
- Cardiovascular Diseases/*epidemiology/*metabolism/physiopathology
- Creatinine/blood/urine
- Diabetes Mellitus
- Type 2/blood/*metabolism/physiopathology/urine
- Double-Blind Method
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
- Humans
- Hypertension/blood/*metabolism/physiopathology/urine
- Kidney/*metabolism/physiopathology
- Male
- Middle Aged
- Predictive Value of Tests
- Proportional Hazards Models
- Randomized Controlled Trials
- Research Design
- Risk Factors
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Eijkelkamp, W. B ...
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Zhang, Z.
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Brenner, B. M.
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Cooper, M. E.
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Devereux, R. B.
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Dahlöf, Björn, 1 ...
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show more...
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Ibsen, H.
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Keane, W. F.
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Lindholm, Lars H
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Olsen, M. H.
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Parving, H. H.
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Remuzzi, G.
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Shahinfar, S.
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Snapinn, S. M.
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Wachtell, K.
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de Zeeuw, D.
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show less...
- Articles in the publication
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J Hypertens
- By the university
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University of Gothenburg
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Umeå University