caa a22 4500 445883022 CHVBK 20180317145550.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10157-011-0420-6 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0420-6 Risk of macrovascular disease stratified by stage of chronic kidney disease in type 2 diabetic patients: critical level of the estimated glomerular filtration rate and the significance of hyperuricemia [Elektronische Daten] [Kentaro Tanaka, Shigeko Hara, Akifumi Kushiyama, Yoshifumi Ubara, Yoko Yoshida, Sonoo Mizuiri, Atsushi Aikawa, Shouji Kawatzu] Background: Although a high prevalence of macrovascular disease (MVD) has been reported in patients with stage 3 chronic kidney disease (CKD), few studies have reported its risk with respect to the underlying cause of kidney disease. This study investigated the prevalence of MVD in type 2 diabetic patients with CKD stratified by CKD stage, as defined by estimated glomerular filtration rate (eGFR), as well as the risk factors for MVD. Methods: 1493 patients with diabetic CKD (1273 males, 220 females) were stratified by CKD stage (stage 1: 39, stage 2: 272, stage 3: 1052, stage 4: 101, stage 5: 29) based on eGFR calculated by the Japanese formula and averaged over 8months. MVD was defined as one of the following: coronary heart disease (CHD), stroke or arteriosclerosis obliterans (ASO). Results: The prevalence of MVD was 18.6%. A significant increasing trend in MVD prevalence was observed from stage 3 (17.78%) to 4 (52.48%). According to a receiver operating characteristic curve analysis on MVD prevalence in stage 3 patients, an eGFR of 46.4ml/min/1.73m2 was determined to be a critical cut-off level. Proteinuria, eGFR <60ml/min/1.73m2 and hyperuricemia were independent risk factors for MVD. Conclusions: In patients with diabetic CKD, a significant increase in MVD prevalence was observed from stage 3 to 4. An eGFR of 46.4ml/min/1.73m2 is a critical level that affects MVD prevalence. From the perspective of cardiorenal association, CKD stage 3 should be divided into two substages. As hyperuricemia is related to an increased risk of MVD, uric acid control may be important in reducing MVD risk in diabetic CKD. Japanese Society of Nephrology, 2011 Type 2 diabetes nationallicence Chronic kidney disease nationallicence Macrovascular disease nationallicence Hyperuricemia nationallicence Tanaka Kentaro Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut Hara Shigeko Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut Kushiyama Akifumi Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut Ubara Yoshifumi Kidney Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan aut Yoshida Yoko Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut Mizuiri Sonoo Department of Nephrology, Toho University School of Medicine, Tokyo, Japan aut Aikawa Atsushi Department of Nephrology, Toho University School of Medicine, Tokyo, Japan aut Kawatzu Shouji Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 391-397 1342-1751 15:3<391 2011 15 10157 https://doi.org/10.1007/s10157-011-0420-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0420-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tanaka Kentaro Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut NATIONALLICENCE 700 1- Hara Shigeko Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut NATIONALLICENCE 700 1- Kushiyama Akifumi Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut NATIONALLICENCE 700 1- Ubara Yoshifumi Kidney Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Yoshida Yoko Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut NATIONALLICENCE 700 1- Mizuiri Sonoo Department of Nephrology, Toho University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Aikawa Atsushi Department of Nephrology, Toho University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Kawatzu Shouji Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, 100-0005, Tokyo, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 391-397 1342-1751 15:3<391 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer