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Aims To investigate the risk prediction and the risk stratification performances of the Chronic Kidney Disease Epidemiology Collaboration ( CKD- EPI) equation and the Modification of Diet in Renal Disease ( MDRD) equation for estimated glomerular filtration rate ( eGFRCKD- EPI vs. eGFRMDRD) on heart failure in patients with Type 2 diabetes. Methods The study cohort included 12 258 White and 16 886 African American low-income patients with Type 2 diabetes who were 30-90 years old at baseline. Heart failure risk according to different eGFRCKD- EPI and eGFRMDRD categories was prospectively assessed. Results During a mean follow-up of 6.5 years, 5043 incident heart failure cases were identified. Multivariable-adjusted hazard ratios ( HRs) of heart failure associated with the eGFRCKD- EPI categories [≥ 90 (reference group), 75-89, 60-74, 30-59 and < 30 ml/min/1.73 m2] were 1.00, 1.11, 1.31, 1.75 and 2.93 ( Ptrend < 0.001) for African American patients, and 1.00, 1.11, 1.08, 1.59 and 2.92 ( Ptrend < 0.001) for White patients, respectively. The model with eGFRCKD- EPI and the other risk factors had significantly higher Harrell's C than the model with eGFRMDRD and other risk factors. Patients reclassified downward from eGFRMDRD 60-74 to eGFRCKD- EPI 30-59 and from eGFRMDRD 30-59 to eGFRCKD- EPI < 30 ml/min/1.73 m2 showed higher heart failure risk than those who were not reclassified. Conclusions Impaired kidney function (i.e. GFR < 60 ml/min/1.73 m2), and even mildly decreased GFR (60-74 ml/min/1.73 m2) estimated by both equations is associated with an increased risk of heart failure. Compared with GFR estimated using the MDRD equation, GFR estimated using the CKD- EPI equation added more predictive power to the model with the other risk factors. Also, eGFRCKD- EPI provided more accurate heart failure risk stratification than eGFRMDRD . [ABSTRACT FROM AUTHOR]

Aim To investigate the race-specific trend in attainment of the American Diabetes Association cardiovascular risk factor control goals (HbA1c <53 mmol/mol (7.0%), blood pressure <130/80 mmHg and LDL cholesterol <2.6mmol/l) by patients with Type 2 diabetes. Methods The study sample included 14 946 African-American and 12 758 white patients who were newly diagnosed with Type 2 diabetes between 2001 and 2009 in the Louisiana State University Hospital system. The race-specific percentages of patients' attainment of American Diabetes Association goals were calculated using the baseline and follow-up measurements of HbA1c, blood pressure, and LDL cholesterol levels. Logistic regression was used to test the difference between African-American and white patients. Results The percentage of patients who met all three American Diabetes Association goals increased from 8.2% in 2001 to 10.2% in 2009 (increased by 24.4%) in this cohort. Compared with African-American patients, white patients had better attainment of the following American Diabetes Association goals: HbA1c (61.4 vs. 55.1%), blood pressure (25.8 vs. 20.4%), LDL cholesterol (40.1 vs. 37.7%) and all three goals (7.3 vs. 5.1%). African-American and white patients generally had a better cardiovascular disease risk factor profile during follow-up when we assessed attainment of the American Diabetes Association goals by means of HbA1c, blood pressure and LDL cholesterol. Conclusions During 2001-2009, the present low-income cohort of people with Type 2 diabetes generally experienced improved control of cardiovascular disease risk factors. White patients had better attainment of the American Diabetes Association cardiovascular risk factor control goals than their African-American counterparts. [ABSTRACT FROM AUTHOR]