Temporal trends in the prevalence of albuminuria and reduced eGFR in Japanese patients with type 2 diabetes
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Changes over time have been shown in renal manifestations in individuals with diabetes in the United States; however, whether the trends are shared across ethnicities is unknown. We conducted this single-center serial cross-sectional study to determine temporal changes in albuminuria and reduced kidney function in Japanese patients with type 2 diabetes. This study included adult Japanese patients with type 2 diabetes who first visited our institute between 2004 and 2013. Temporal changes during the 10 years in the frequency of albuminuria ( ≥ 30 mg/g creatinine) and reduced eGFR ( < 60 mL/min/1.73 m2) were analyzed using the univariate and multivariate logistic regression analyses and Granger causality test. 5331 Japanese patients with type 2 diabetes, 1892 women and 3439 men, with the mean age of 56 ± 13 years, were studied. There was no change in the prevalence of albuminuria in the univariate analysis; however, a significantly decreasing trend was observed after adjustment for several covariates. On the other hand, patients with reduced eGFR significantly increased over time, although the statistical significance disappeared after adjustment for the covariates, including levels of serum uric acid and hemoglobin and use of renin–angiotensin inhibitors. The Granger causality test showed that time series for use of RAS inhibitors and BMI had a causative role in time series for reduced eGFR. In conclusion, prevalence of albuminuria decreased and that of reduced eGFR remained stable after adjustment for clinical characteristics in Japanese patients with type 2 diabetes during the last decade.
KeywordsAlbuminuria eGFR Type 2 diabetes Granger causality
NT designed the study, collected the data, performed the statistical analyses, researched data, and wrote the manuscript. YYa, YYo, TM, and KH substantially contributed to collection and interpretation of data. TB is the guarantor of this work, had full access to all the data in the study, performed the statistical analyses in part, reviewed/edited the manuscript, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Compliance with ethical standards
Conflicts of interest
The authors have nothing to declare.
Human rights statement
The present study was conducted as a part of the Prospective Cohort Study Elucidating Factors Associated with the Pathogenesis, Prognosis, and Prognosis of Diabetic Nephropathy conducted in Diabetes Center, Tokyo Women’s Medical University, the protocol of which was approved by the Ethics Committee of Tokyo Women’s Medical University School of Medicine (Approval No. 1584)
Since this was an observational but not a prospective intervention study, the Ethics Committee provided a waiver of informed consent.
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