Evidence map›Paper›PMID 24925722›Full record

Trial reportJournal of the American Society of Nephrology : JASN2014

Renal outcomes in patients with type 1 diabetes and macroalbuminuria.

Ian H de Boer, Maryam Afkarian, Tessa C Rue, Patricia A Cleary, John M Lachin, Mark E Molitch, Michael W Steffes, Wanjie Sun, Bernard Zinman, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group

Open access · greenAbstract readMulticenter StudyObservational StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 5 pooled it
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 5 syntheses or guidelines pooled it, 95 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Pooled it
  4. Glucose targets for preventing diabetic kidney disease and its progression.The Cochrane database of systematic reviews · 2017
    Pooled it
  5. Pooled it
  6. JAK1/JAK2 inhibition by baricitinib in diabetic kidney disease: results from a Phase 2 randomized controlled clinical trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018
    Trial
  7. Trial
  8. Trial
  9. Measuring urine albumin and total protein.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Review
  10. Article
  11. Article
  12. Observational
  13. Review
  14. Article
  15. Review
  16. Review
  17. Article
  18. Review
  19. Diabetic kidney disease in children and adolescents: an update.Pediatric nephrology (Berlin, Germany) · 2022
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 4 countries.

Ian H de BoerDivision of Nephrology and Kidney Research Institute and deboer@u.washington.edu.
Maryam AfkarianDivision of Nephrology and Kidney Research Institute and.
Tessa C RueDepartment of Biostatistics, University of Washington, Seattle, Washington;
Patricia A ClearyBiostatistics Center, The George Washington University, Rockville, Maryland;
John M LachinBiostatistics Center, The George Washington University, Rockville, Maryland;
Mark E MolitchDivision of Endocrinology, Northwestern University, Chicago, Illinois;
Michael W SteffesDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota; and.
Wanjie SunBiostatistics Center, The George Washington University, Rockville, Maryland;
Bernard ZinmanSamuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group
George Washington University · USKidney Research UK · GBMount Sinai Hospital · CANorthwestern University · USUniversity of Minnesota · USUniversity of Washington · US

Funding

Vector and Transgenic Mouse CoreP30DK017047 · NIDDK · UNIVERSITY OF WASHINGTON · PI Karin E Bornfeldt · 1986 to 2026
$41.4M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR000114 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R · 2012 to 2015
$35.0M
Yale University Clinical and Translational Science Award ProgramUL1TR000142 · NCATS · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2012 to 2015
$31.8M
Epidemiology of Diabetes Interventions and Complications Data Coordinating CenterU01DK094176 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI BEBU, IONUT, BRAFFETT, BARBARA HALINA · 2012 to 2022
$30.8M
Randomized trial of vitamin D and omega-3 fatty acids for diabetic kidney diseaseR01DK088762 · NIDDK · UNIVERSITY OF WASHINGTON · PI DE BOER, IAN H · 2010 to 2019
$4.7M
Insulin Resistance in Chronic Kidney DiseaseR01DK087726 · NIDDK · UNIVERSITY OF WASHINGTON · PI DE BOER, IAN H · 2010 to 2013
$1.9M
Molecular signatures of diabetic kidney diseaseR01DK104706 · NIDDK · UNIVERSITY OF WASHINGTON · PI AFKARIAN, MARYAM · 2015 to 2017
$1.3M
Identifying urinary biomarkers for early type 2 diabetic nephropathyK23DK089017 · NIDDK · UNIVERSITY OF WASHINGTON · PI AFKARIAN, MARYAM · 2010 to 2014
$745k
NCATS NIH HHS UL1 TR000114NCATS NIH HHS UL1 TR000142NIDDK NIH HHS K23 DK089017NIDDK NIH HHS P30 DK017047NIDDK NIH HHS R01 DK087726NIDDK NIH HHS R01 DK088762NIDDK NIH HHS R01 DK104706NIDDK NIH HHS U01 DK094176
6 · The paper itself

Abstract

Macroalbuminuria, defined as urine albumin excretion rate (AER)≥300 mg/d, has long been considered a stage of irreversible kidney damage that leads reliably to GFR loss. We examined the long-term renal outcomes of persons with type 1 diabetes who developed incident macroalbuminuria during the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study. One hundred fifty-nine participants developed incident macroalbuminuria and were subsequently followed for a median duration of 9 years (maximum of 25 years). At the time of macroalbuminuria diagnosis, mean (SD) age was 37 (9) years, mean (SD) duration of diabetes was 17 (5) years, median AER was 524 mg/d, and mean (SD) eGFR was 108 (20) ml/min per 1.73 m(2). Ten years after macroalbuminuria diagnosis, the cumulative incidence of a sustained reduction in AER to <300 mg/d was 52%, mostly but not entirely under treatment with renin-angiotensin system inhibitors. The cumulative incidence of impaired GFR (sustained eGFR<60 ml/min per 1.73 m(2)) 10 years after macroalbuminuria diagnosis was 32%, including 16% who developed ESRD. Lower hemoglobin A1c and BP and regression to AER<300 mg/d were associated with reduced risk of developing impaired GFR. In conclusion, people with type 1 diabetes who develop macroalbuminuria are at high risk of progressive kidney disease. However, through at least 10 years of follow-up, AER could often be controlled, and GFR frequently remained in the normal range.

Indexed as

AdultAlbuminuriaDiabetes Mellitus, Type 1Diabetic NephropathiesDisease ProgressionFemaleGlomerular Filtration RateHumansIncidenceMaleMiddle AgedNorth AmericaRisk Factors

Identifiers

PMID24925722
PMCPMC4178441
OpenAlexW2125793303

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.