Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study

Abstract Objective We evaluated the interaction of urinary protein-to-creatinine ratio (UPCR) with diabetes on the risk of cardiovascular events in a cohort study. Methods The study population consisted of 639 participants with chronic kidney disease (CKD) stages 2–5, enrolled between 2010 and 2011...

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Main Authors: Shahi Kishor, Jianrong Chen, Yan Zhang, Wei Liu, Lingyan Zhu, Jixiong Xu, Jiancheng Wang
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-20715-2
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author Shahi Kishor
Jianrong Chen
Yan Zhang
Wei Liu
Lingyan Zhu
Jixiong Xu
Jiancheng Wang
author_facet Shahi Kishor
Jianrong Chen
Yan Zhang
Wei Liu
Lingyan Zhu
Jixiong Xu
Jiancheng Wang
author_sort Shahi Kishor
collection DOAJ
description Abstract Objective We evaluated the interaction of urinary protein-to-creatinine ratio (UPCR) with diabetes on the risk of cardiovascular events in a cohort study. Methods The study population consisted of 639 participants with chronic kidney disease (CKD) stages 2–5, enrolled between 2010 and 2011 in Japan. Cox proportional hazards models were used to evaluate the independent and combined effects of the UPCR and diabetes on cardiovascular events. Results During a median follow-up of 3 years, 59 participants developed cardiovascular events during follow-up. A notably higher risk of cardiovascular events was found in participants with proteinuria [hazards ratio (HR): 2.16, 95% confidence interval (95% CI): 1.17–3.97] compared to those without proteinuria at UPCR levels. In addition, the participants with diabetes had a higher risk of cardiovascular events (HR: 2.53, 95% CI: 1.49–4.30) than those without diabetes. Moreover, an interaction was found between UPCR and diabetes on cardiovascular events (P for interaction = 0.04). Participants with both proteinuria (UPCR ≥ 0.5 g/gCr) and diabetes had a 4.09 times higher risk of cardiovascular events (HR: 4.09, 95% CI: 1.97–8.47) compared with those without proteinuria (UPCR < 0.5 g/gCr) and diabetes. Conclusions In summary, among participants with CKD stages 2–5, proteinuria and diabetes were found to independently and jointly affect the risk of cardiovascular events. Participants with proteinuria and diabetes had the highest risk of cardiovascular events compared with other groups.
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spelling doaj-art-cbb065a2190643a69c2e7764497402c22025-08-20T02:22:32ZengBMCBMC Public Health1471-24582024-11-012411710.1186/s12889-024-20715-2Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE studyShahi Kishor0Jianrong Chen1Yan Zhang2Wei Liu3Lingyan Zhu4Jixiong Xu5Jiancheng Wang6Department of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityDepartment of Endocrinology and Metabolism, First Affiliated Hospital, Jiangxi Medical College, Nanchang UniversityAbstract Objective We evaluated the interaction of urinary protein-to-creatinine ratio (UPCR) with diabetes on the risk of cardiovascular events in a cohort study. Methods The study population consisted of 639 participants with chronic kidney disease (CKD) stages 2–5, enrolled between 2010 and 2011 in Japan. Cox proportional hazards models were used to evaluate the independent and combined effects of the UPCR and diabetes on cardiovascular events. Results During a median follow-up of 3 years, 59 participants developed cardiovascular events during follow-up. A notably higher risk of cardiovascular events was found in participants with proteinuria [hazards ratio (HR): 2.16, 95% confidence interval (95% CI): 1.17–3.97] compared to those without proteinuria at UPCR levels. In addition, the participants with diabetes had a higher risk of cardiovascular events (HR: 2.53, 95% CI: 1.49–4.30) than those without diabetes. Moreover, an interaction was found between UPCR and diabetes on cardiovascular events (P for interaction = 0.04). Participants with both proteinuria (UPCR ≥ 0.5 g/gCr) and diabetes had a 4.09 times higher risk of cardiovascular events (HR: 4.09, 95% CI: 1.97–8.47) compared with those without proteinuria (UPCR < 0.5 g/gCr) and diabetes. Conclusions In summary, among participants with CKD stages 2–5, proteinuria and diabetes were found to independently and jointly affect the risk of cardiovascular events. Participants with proteinuria and diabetes had the highest risk of cardiovascular events compared with other groups.https://doi.org/10.1186/s12889-024-20715-2Urinary protein-to-creatinine ratioDiabetesProteinuriaChronic kidney diseaseCardiovascular disease
spellingShingle Shahi Kishor
Jianrong Chen
Yan Zhang
Wei Liu
Lingyan Zhu
Jixiong Xu
Jiancheng Wang
Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study
BMC Public Health
Urinary protein-to-creatinine ratio
Diabetes
Proteinuria
Chronic kidney disease
Cardiovascular disease
title Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study
title_full Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study
title_fullStr Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study
title_full_unstemmed Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study
title_short Interaction of proteinuria and diabetes on the risk of cardiovascular events: a prospective cohort CKD-ROUTE study
title_sort interaction of proteinuria and diabetes on the risk of cardiovascular events a prospective cohort ckd route study
topic Urinary protein-to-creatinine ratio
Diabetes
Proteinuria
Chronic kidney disease
Cardiovascular disease
url https://doi.org/10.1186/s12889-024-20715-2
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