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Plasma copeptin and renal outcomes in patients with type 2 diabetes and albuminuria.
- Source :
-
Diabetes care [Diabetes Care] 2013 Nov; Vol. 36 (11), pp. 3639-45. Date of Electronic Publication: 2013 Jul 17. - Publication Year :
- 2013
-
Abstract
- Objective: Plasma copeptin, a surrogate for vasopressin, was associated with albuminuria in population-based studies. These associations are consistent with the effect of vasopressin on albuminuria observed in humans and rodents. The objective of this study was to determine whether plasma copeptin is an independent marker of risk of renal events in people with type 2 diabetes and albuminuria.<br />Research Design and Methods: We studied 3,101 participants of the DIABHYCAR trial (6-year follow-up) with type 2 diabetes and albuminuria. A renal event was defined as doubling of serum creatinine or development of end-stage renal disease.<br />Results: During follow-up, 86 renal events occurred in 76 subjects (2.45%). Incidences by tertiles of baseline plasma copeptin were 1.06% (T1), 1.45% (T2), and 4.84% (T3). They were 2.43% (T1), 5.11% (T2), and 11.81% (T3) for the subset of subjects with macroalbuminuria at baseline (n = 729). Hazard ratio for plasma copeptin tertiles as a risk for renal events was 4.79 (95% CI, 2.48-9.24; P < 0.0001; for T3 vs. T1). In a stepwise regression analysis, urinary albumin excretion and plasma copeptin remained positively associated and HDL cholesterol and estimated glomerular filtration rate were inversely associated with the incidence of renal events. These independent predictors explained ∼18% of the variance of the outcome. The yearly variations of estimated glomerular filtration rate by copeptin tertiles were -1.43 ± 0.51 (T1), -2.29 ± 0.49 (T2), and -3.52 ± 0.44 mL/min/1.73 m2 per year (T3) (P = 0.005) in subjects with macroalbuminuria.<br />Conclusions: Plasma copeptin may help to identify subjects with diabetic chronic kidney disease who are at high risk for renal function decline.
- Subjects :
- Aged
Albuminuria blood
Arginine Vasopressin
Biomarkers blood
Diabetes Mellitus, Type 2 blood
Diabetic Nephropathies blood
Female
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic blood
Kidney Function Tests
Male
Middle Aged
Albuminuria etiology
Diabetes Mellitus, Type 2 complications
Diabetic Nephropathies etiology
Glycopeptides blood
Kidney Failure, Chronic etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 36
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 23863910
- Full Text :
- https://doi.org/10.2337/dc13-0683