Resumo

GIMENO-ORNA, José Antonio et al. Risk of mortality associated to chronic kidney disease in patients with type 2 diabetes mellitus: a 13-year follow-up. Nefrología (Madr.) [online]. 2015, vol.35, n.5, pp.487-492. ISSN 1989-2284.  https://dx.doi.org/10.1016/j.nefro.2015.05.025.

Objective: Our aim was to assess the usefulness of glomerular filtration rate (GFR) and urinary albumin excretion (UAE) to predict the risk of mortality in patients with type 2 diabetes mellitus. Material and methods: This is a prospective cohort study in patients with type 2 diabetes mellitus. Clinical end-point was mortality rate. GFR was measured in ml/min/1.73 m² and stratified in 3 categories (=60; 45-59; <45); UAE was measured in mg/24 hours and was also stratified in 3 categories (<30; 30-300; >300). Mortality rates were reported per 1000 patient-years. Cox regression models were used to predict mortality risk associated with combined GFR and UAE. The predictive power was estimated with C-Harrell statistic. Results: A total of 453 patients (39.3% males), aged 64.9 (SD 9.3) years were included; mean diabetes duration was 10.4 (SD 7.5) years. Median follow-up was 13 years. Total mortality rate was 39.5/1000. The progressive increase in mortality in the successive categories of GFR and UAE was statistically significant (P<.001). In a multivariable analysis, UAE (HR30-300 = 1.02 and HR > 300 = 2.83; X2 = 11.6; P =.003) and GFR (HR45-59 = 1.34 and HR < 45=1.84; X2 = 6.4; P =.041) were independent predictors for mortality, with no significant interaction. Simultaneous inclusion of GFR and UAE improved the predictive power of models (C-Harrell 0.741 vs. 0.726; P =.045). Conclusions: GFR and UAE are independent predictors for mortality in type 2 diabetic patients and do not show a statistically significant interaction.

Palavras-chave : Type 2 diabetes mellitus; Mortality; Chronic renal failure.

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