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Additional file 1: Supplemental methods. Supplementary Figure 1. Steps of multiple imputation (for more details see Appendix A). Supplementary Table 1. Characteristics of BBD histology and breast cancers among cases by calendar year of BBD and breast cancer diagnoses (N = 514). Supplemental Table 2. Comparison of associations between select patient characteristics and histologic features with breast cancer risk in conditional and unconditional logistic regression models using multiple imputation dataset (N = 1028). Supplemental Table 3. Associations between select patient characteristics and histologic features with breast cancer risk by tumor grade (N = 922). Supplemental Table 4. Associations between select patient characteristics and histologic features with breast cancer risk by tumor size (N = 1013). Supplementary Table 5. Associations between demographic and histologic features with breast cancer risk by BBD calendar year before vs. after 1993 (N = 1028). Appendix A. Distribution of numeric variables before (top) and after (bottom) multiple imputations.

Additional file 1: Table S1. Comparison of age, sex, and use of RAAS blockade for all patients with and without diabetes in each baseline eGFR and UACR/DP category. Table S2. Crude annualized absolute and percent decline in eGFR by baseline eGFR and UACR/DP categories among patients with a baseline and follow-up eGFR with and without diabetes. Figure S1. 1-year probabilities (95% CI) of progressing to a higher eGFR stage and of all-cause mortality by baseline eGFR and UACR/DP categories for patients with and without diabetes. The probabilities are based on life table analysis over a maximum follow-up of 11 years. Figure S2. 3-year probabilities (95% CI) of progressing to a higher eGFR stage and of all-cause mortality by baseline eGFR and UACR/DP categories for patients with and without diabetes. The probabilities are based on life table analysis over a maximum follow-up of 11 years. Figure S3. 5-year probabilities (95% CI) of progressing to a higher eGFR stage and of all-cause mortality by baseline eGFR and UACR/DP categories for patients with and without diabetes. The probabilities are based on life table analysis over a maximum follow-up of 11 years.

Background Studies of progression of kidney dysfunction typically focus on renal replacement therapy or percentage decline in estimated glomerular filtration rate (eGFR) as outcomes. Our aim was to compare real-world patients with and without T2D to estimate progression from and to clinically defined categories of kidney disease and all-cause mortality. Methods This was an observational cohort study of 31,931 patients with and 33,201 age/sex matched patients without type 2 diabetes (T2D) who had a serum creatinine and urine albumin-to-creatinine ratio (UACR) or dipstick proteinuria (DP) values. We used the first available serum creatinine value between 2006 and 2012 to calculate baseline eGFR and categorized them and the corresponding UACR/DP values using the Kidney Disease Improving Global Outcomes (KDIGO) categories. To assess our primary outcomes, we extracted probabilities of eGFR progression or mortality from life-table analyses and conducted multivariable Cox regression analyses of relative risk adjusted for age, sex, race/ethnicity, smoking, ischemic heart disease, heart failure, and use of renal-angiotensin-aldosterone system inhibitors. Results Patterns of eGFR decline were comparable among patients with vs. without T2D with larger percentage declines at higher albuminuria levels across all eGFR categories. eGFR decline was generally larger among T2D patients, particularly in those with severely increased albuminuria. Across all CKD categories, risk of progression to the next higher category of eGFR was substantially increased with increasing albuminuria. For example, the risk was 23.5, 36.2, and 65.1% among T2D patients with eGFR 30–59 ml/min/1.73m2 and UACR 300 mg/dL, respectively (p 60 ml/min/1.73m2 with normal to mildly increased albuminuria). Conclusions Presence of albuminuria was associated with accelerated eGFR decline independent of T2D. Risk for adverse outcomes was remarkably high among patients with CKD and normal to mildly increased albuminuria levels. Independent of T2D or albuminuria, a substantial risk for adverse outcomes exists for CKD patients in a routine care setting.