ArticleDiabetologia2014
Mortality and morbidity in relation to changes in albuminuria, glucose status and systolic blood pressure: an analysis of the ONTARGET and TRANSCEND studies.
Article in Diabetologia, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Drug-Induced Reduction in Albuminuria Is Associated with Subsequent Renoprotection: A Meta-Analysis.Journal of the American Society of Nephrology : JASN · 2015Pooled it
- Dapagliflozin reduces albuminuria over 2 years in patients with type 2 diabetes mellitus and renal impairment.Diabetologia · 2016Trial
- The use of green tea polyphenols for treating residual albuminuria in diabetic nephropathy: A double-blind randomised clinical trial.Scientific reports · 2016Trial
- The Synergistic Treatment of Heart and Kidney Disease.Deutsches Arzteblatt international · 2026Review
- Diabetic Nephropathy: Update on Pillars of Therapy Slowing Progression.Diabetes care · 2023Review
- Leveraging the South African Diabetes Prevention Programme to screen for chronic kidney disease: an observational study.BMJ open · 2023Observational
- Efficacy and Safety of Finerenone in Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.Frontiers in pharmacology · 2022Review
- Change in Urine Albumin-to-Creatinine Ratio and Risk of Diabetic Peripheral Neuropathy in Type 2 Diabetes: A Retrospective Cohort Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Frequency of alcohol drinking modifies the association between salt intake and albuminuria: a 1-year observational study.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Observational
- Effect of a Single Intravitreal Bevacizumab Injection on Proteinuria in Patients With Diabetes.Translational vision science & technology · 2020Article
- Article
- Microalbuminuria and cardiorenal risk: old and new evidence in different populations.F1000Research · 2019Review
- Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach.Diabetologia · 2018Review
- Intravital imaging of the kidney in a rat model of salt-sensitive hypertension.American journal of physiology. Renal physiology · 2017Article
- Protective effect of rosiglitazone on kidney function in high-fat challenged human-CRP transgenic mice: a possible role for adiponectin and miR-21?Scientific reports · 2017Article
- Article
- Additive Effect of Qidan Dihuang Grain, a Traditional Chinese Medicine, and Angiotensin Receptor Blockers on Albuminuria Levels in Patients with Diabetic Nephropathy: A Randomized, Parallel-Controlled Trial.Evidence-based complementary and alternative medicine : eCAM · 2016Article
- The glycocalyx--linking albuminuria with renal and cardiovascular disease.Nature reviews. Nephrology · 2015Review
- Diabetic nephropathy in 2014: improved cardiorenal prognosis in diabetic nephropathy.Nature reviews. Nephrology · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisUrinary albumin excretion is a strong predictor of cardiovascular disease. It is uncertain whether improvement from microalbuminuria or deterioration from normoalbuminuria over time in patients with differing changes in glucose and BP change their cardiovascular risk.
methodsData on mortality, cardiovascular and renal outcomes were analysed in 22,984 patients from two large parallel randomised clinical trials followed for 56 months. A central laboratory analysed first morning spot urine samples at baseline and after 24 months, and events were recorded over the subsequent 32 months. Patients were stratified by changes in albuminuria, glucose status and mean systolic BP over 2 years.
resultsThere was a strong association between albuminuria status and all-cause and cardiovascular mortality and combined cardiovascular and renal endpoints (all p < 0.0001). Changes in systolic BP control had no effect on mortality, whereas glucose status was significantly associated with all outcomes. Irrespective of BP control or glucose status, patients showing an improvement from microalbuminuria to normoalbuminuria after 2 years were at a lower risk of all outcome measures than patients showing deterioration from normoalbuminuria to microalbuminuria (HR for all-cause mortality 0.65 [0.52-0.83], p = 0.0004). CONCLUSIONS/
interpretationPatients who showed improvement to normoalbuminuria over 2 years were at lower risk of all-cause and cardiovascular mortality and of cardiovascular and renal events than those who deteriorated to microalbuminuria over time. Albuminuria over time was significantly better than glucose status and BP control in predicting mortality and both cardiovascular and renal outcomes in patients at a high cardiovascular risk.
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Registered trials
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.