Abstract：
BACKGROUND: Diabetic kidney disease is the most common cause of end-stage kidney disease (ESKD) in the western world. Rapid estimated glomerular filtration rate (eGFR) decline is an independent predictor of ESKD and death in the general population and in subjects with type 2 diabetes mellitus (T2D).
OBJECTIVE: We investigated in a large sample of subjects with newly diagnosed T2D the prevalence and clinical determinants of fast eGFR decline, taking advantage from the dataset of the Associazione Medici Diabetologi (AMD) Annals initiative.
METHODS: The eGFR trajectories were evaluated by applying a linear mixed model for repeated measures (LMMRM) and rapid eGFR decline defined as an eGFR decline greater than 5 mL/min/1.73 m2 per year at 3 years.
RESULTS: Among 105,163 (57.7% M) subjects with newly diagnosed T2D, 13,587 (12.9 %) subjects showed a rapid eGFR loss. The independent significant predictors were age, female gender, HbA1c, smoking, high baseline eGFR, albuminuria and retinopathy.
CONCLUSIONS: Our study demonstrates that a significant percentage of newly diagnosed T2D subjects have a rapid eGFR decline. Given the association between dynamic changes in eGFR and the risk of ESKD or death, we suggest to include this variable in the definition of CKD.
OBJECTIVE: We investigated in a large sample of subjects with newly diagnosed T2D the prevalence and clinical determinants of fast eGFR decline, taking advantage from the dataset of the Associazione Medici Diabetologi (AMD) Annals initiative.
METHODS: The eGFR trajectories were evaluated by applying a linear mixed model for repeated measures (LMMRM) and rapid eGFR decline defined as an eGFR decline greater than 5 mL/min/1.73 m2 per year at 3 years.
RESULTS: Among 105,163 (57.7% M) subjects with newly diagnosed T2D, 13,587 (12.9 %) subjects showed a rapid eGFR loss. The independent significant predictors were age, female gender, HbA1c, smoking, high baseline eGFR, albuminuria and retinopathy.
CONCLUSIONS: Our study demonstrates that a significant percentage of newly diagnosed T2D subjects have a rapid eGFR decline. Given the association between dynamic changes in eGFR and the risk of ESKD or death, we suggest to include this variable in the definition of CKD.
摘要：
背景：糖尿病肾病是西方终末期肾病（ESKD）的最常见原因。在普通人群和2型糖尿病（T2D）受试者中，快速估计的肾小球滤过率（eGFR）下降是ESKD和死亡的独立预测因子。
目的：我们在大量新诊断为T2D的受试者中调查了eGFR快速下降的患病率和临床决定因素，利用AssociazioneMediciDiabetologi（AMD）年鉴计划的数据集。
方法：通过应用线性混合模型对重复测量（LMMRM）和快速eGFR下降进行评估，eGFR下降定义为3年时每年eGFR下降大于5mL/min/1.73m2。
结果：在105,163名（57.7％M）新诊断为T2D的受试者中，13,587名(12.9%)受试者表现出快速的eGFR损失。独立的显著预测因素是年龄，女性性别,HbA1c,吸烟,高基线eGFR，蛋白尿和视网膜病变。
结论：我们的研究表明，新诊断的T2D受试者中有显著百分比的eGFR快速下降。鉴于eGFR的动态变化与ESKD或死亡风险之间的关联，我们建议在CKD的定义中加入这个变量.
目的：我们在大量新诊断为T2D的受试者中调查了eGFR快速下降的患病率和临床决定因素，利用AssociazioneMediciDiabetologi（AMD）年鉴计划的数据集。
方法：通过应用线性混合模型对重复测量（LMMRM）和快速eGFR下降进行评估，eGFR下降定义为3年时每年eGFR下降大于5mL/min/1.73m2。
结果：在105,163名（57.7％M）新诊断为T2D的受试者中，13,587名(12.9%)受试者表现出快速的eGFR损失。独立的显著预测因素是年龄，女性性别,HbA1c,吸烟,高基线eGFR，蛋白尿和视网膜病变。
结论：我们的研究表明，新诊断的T2D受试者中有显著百分比的eGFR快速下降。鉴于eGFR的动态变化与ESKD或死亡风险之间的关联，我们建议在CKD的定义中加入这个变量.
