ArticleDiabetes2024
Cardiovascular Autonomic Neuropathy and Risk of Kidney Function Decline in Type 1 and Type 2 Diabetes: Findings From the PERL and ACCORD Cohorts.
Article in Diabetes, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 13 citations in OpenAlex.
- Inflammatory Markers and Measures of Cardiovascular Autonomic Neuropathy in Type 1 Diabetes.Journal of the American Heart Association · 2025Trial
- Cardiovascular Autonomic Neuropathy and Indices of Heart Failure in Type 2 Diabetes: The CANCAN Study.Diabetes, obesity & metabolism · 2026Article
- Cardiac autonomic neuropathy predicts renal decline in type 1 diabetes mellitus: a 15 year follow-up study.Diabetologia · 2026Article
- Diabetic peripheral neuropathy as an independent predictor of renal function decline in type 2 diabetes: a propensity score-matched retrospective cohort study using DPN-CheckClinical and experimental nephrology · 2026Article
- Development and validation of a nomogram model for predicting cardiac autonomic neuropathy in patients with diabetes.Frontiers in endocrinology · 2026Article
- An integrative analysis of cardiac autonomic neuropathy and nephropathy risk assessed with SUDOSCAN in individuals with type 2 diabetes.Frontiers in endocrinology · 2026Article
- Cardiac Autonomic Neuropathy and Its Impact on Progression of Diabetic Kidney Disease in Type 1 and Type 2 Diabetes.Kidney medicine · 2025Review
- Empagliflozin reduces liver fibrosis by restoring catechol-O-methyltransferase activity associated with magnesium levels.Scientific reports · 2025Article
- Heart rate variability tests for diagnosing cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus in advanced stages of kidney disease.Cardiovascular diabetology · 2025Article
- Association of baseline and trajectory of triglyceride-glucose index with the incidence of cardiovascular autonomic neuropathy in type 2 diabetes mellitus.Cardiovascular diabetology · 2025Article
- Heart rate variability indices for predicting cardiorenal outcomes: A lesson from the PERL and ACCORD cohorts.Journal of diabetes investigation · 2025Article
- Article
- Risk factors for rapid kidney function decline in diabetes patients.Renal failure · 2024Review
- Sudoscan's Effectiveness in Identifying Chronic Kidney Disease in Patients With Type 2 Diabetes.Cureus · 2024Article
- The Effect of Exercise on Cardiovascular Autonomic Nervous Function in Patients with Diabetes: A Systematic Review.Healthcare (Basel, Switzerland) · 2023Review
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
Results of previous studies have suggested that cardiovascular autonomic neuropathy (CAN) may predict rapid kidney function decline among people with diabetes. We analyzed the association between baseline CAN and subsequent glomerular filtration rate (GFR) decline among individuals with type 1 diabetes (T1D) from the Preventing Early Renal Loss in Diabetes (PERL) study (N = 469) and with type 2 diabetes (T2D) from Action to Control Cardiovascular Risk in Diabetes (ACCORD) (N = 7,973). Baseline CAN was ascertained with electrocardiogram-derived heart rate variability indices. Its association with GFR slopes, rapid kidney function decline (GFR loss of ≥5 mL/min/1.73 m2/year), and ≥40% GFR loss was evaluated by linear mixed-effects, logistic, and Cox regression, respectively. Participants with CAN experienced more rapid GFR decline, by an excess 1.15 mL/min/1.73 m2/year (95% CI -1.93 to -0.37; P = 4.0 × 10-3) in PERL and 0.34 mL/min/1.73 m2/year (95% CI -0.49 to -0.19; P = 6.3 × 10-6) in ACCORD. This translated to 2.11 (95% CI 1.23-3.63; P = 6.9 × 10-3) and 1.39 (95% CI 1.20-1.61; P = 1.1 × 10-5) odds ratios of rapid kidney function decline in PERL and ACCORD, respectively. Baseline CAN was also associated with a greater risk of ≥40% GFR loss events during follow-up (hazard ratio 2.60 [95% CI 1.15-5.45], P = 0.02, in PERL and hazard ratio 1.54 [95% CI 1.28-1.84], P = 3.8 × 10-6, in ACCORD). These associations remained significant after adjustment for potential confounders, including baseline GFR and albuminuria. Our findings indicate that CAN is a strong, independent predictor of rapid kidney function decline in both T1D and T2D. Further studies of the link between these two complications may help with development of new therapies to prevent kidney function decline in patients with diabetes. ARTICLE HIGHLIGHTS:
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