Trial reportJournal of the American Society of Nephrology : JASN2019
Changes in Albuminuria But Not GFR are Associated with Early Changes in Kidney Structure in Type 2 Diabetes.
Trial report in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
43 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease.The Cochrane database of systematic reviews · 2024Pooled it
- Epigenome-wide meta-analysis identifies DNA methylation biomarkers associated with diabetic kidney disease.Nature communications · 2022Pooled it
- Genome-wide meta-analysis and omics integration identifies novel genes associated with diabetic kidney disease.Diabetologia · 2022Pooled it
- Urinary Proteomics Identifies Cathepsin D as a Biomarker of Rapid eGFR Decline in Type 1 Diabetes.Diabetes care · 2022Pooled it
- Postprandial glucagon-like peptide 1 secretion is associated with urinary albumin excretion in newly diagnosed type 2 diabetes patients.World journal of diabetes · 2023Trial
- Acarbose Reduces Low-Grade Albuminuria Compared to Metformin in Chinese Patients with Newly Diagnosed Type 2 Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Trial
- Multimorbidity patterns and the subsequent risk of albuminuria: findings from the Stockholm Creatinine Measurements (SCREAM) project.BMC medicine · 2026Article
- Article
- Plasma R-spondin 2 levels are associated with the progression of diabetic kidney disease.Frontiers in endocrinology · 2026Article
- Risk factors for progression to albuminuria in individuals with newly diagnosed type 2 diabetes: a 5-year cohort study.BMC endocrine disorders · 2025Observational
- Integrating and Simplifying Evidence to Optimize Cardiorenal Guideline-Directed Therapies.Journal of clinical medicine · 2025Review
- Clinically meaningful eGFR slope as a surrogate endpoint differs across CKD stages and slope evaluation periods: the CKD-JAC study.Clinical kidney journal · 2025Article
- Comprehensive management application of sulodexide on proteinuria: 2 case reports.Frontiers in medicine · 2025Article
- Body mass index modifies the effect of urinary protein-to-creatinine ratio on chronic kidney disease progression.International urology and nephrology · 2024Article
- Insulin resistance before type 2 diabetes onset is associated with increased risk of albuminuria after diabetes onset: A prospective cohort study.Diabetes, obesity & metabolism · 2024Article
- Development of an automated estimation of foot process width using deep learning in kidney biopsies from patients with Fabry, minimal change, and diabetic kidney diseases.Kidney international · 2024Article
- Trajectories of eGFR and risk of albuminuria in youth with type 2 diabetes: results from the TODAY cohort study.Pediatric nephrology (Berlin, Germany) · 2023Article
- [Non-Classical Clinical Types and Pathological Changes of Diabetic Kidney Disease: A Review].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2023Review
- Loss of Glomerular Permselectivity in Type 2 Diabetes Associates With Progression to Kidney Failure.Diabetes · 2023Article
- Diagnostic criteria and etiopathogenesis of type 2 diabetes and its complications: Lessons from the Pima Indians.Presse medicale (Paris, France : 1983) · 2023Review
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundIn type 1 diabetes, changes in the GFR and urine albumin-to-creatinine ratio (ACR) are related to changes in kidney structure that reflect disease progression. However, such changes have not been studied in type 2 diabetes.
methodsParticipants were American Indians with type 2 diabetes enrolled in a clinical trial of losartan versus placebo. We followed a subset who underwent kidney biopsy at the end of the 6-year trial, with annual measurements of GFR (by urinary clearance of iothalamate) and ACR. Participants had a second kidney biopsy after a mean follow-up of 9.3 years. We used quantitative morphometric analyses to evaluate both biopsy specimens.
resultsBaseline measures for 48 participants (12 men and 36 women, mean age 45.6 years) who completed the study included diabetes duration (14.6 years), GFR (156 ml/min), and ACR (15 mg/g). During follow-up, glomerular basement membrane (GBM) width, mesangial fractional volume, and ACR increased, and surface density of peripheral GBM and GFR decreased. After adjustment for sex, age, ACR, and each morphometric variable at baseline, an increase in ACR during follow-up was significantly associated with increases in GBM width, mesangial fractional volume, and mean glomerular volume, and a decrease in surface density of peripheral GBM. Decline in GFR was not associated with changes in these morphometric variables after additionally adjusting for baseline GFR.
conclusionsIn American Indians with type 2 diabetes and preserved GFR at baseline, increasing ACR reflects the progression of earlier structural glomerular lesions, whereas early GFR decline may not accurately reflect such lesions.
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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.