Publication Date

12-1-2023

Journal

Pediatric Nephrology

DOI

10.1007/s00467-023-06044-3

PMID

37434027

PMCID

PMC10875681

PubMedCentral® Posted Date

12-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Female, Adolescent, Diabetes Mellitus, Type 2, Cohort Studies, Glomerular Filtration Rate, Diabetic Nephropathies, Albuminuria, Follow-Up Studies, Risk Factors, Disease Progression, Diabetic kidney disease, type 2 diabetes, youth, glomerular filtration rate, albuminuria, hyperfiltration, trajectories

Abstract

BACKGROUND: We conducted exploratory analyses to identify distinct trajectories of estimated glomerular filtration rate (eGFR) and their relationship with hyperfiltration, subsequent rapid eGFR decline, and albuminuria in participants with youth-onset type 2 diabetes enrolled in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study.

METHODS: Annual serum creatinine, cystatin C, urine albumin, and creatinine measurements were obtained from 377 participants followed for ≥ 10 years. Albuminuria and eGFR were calculated. Hyperfiltration peak is the greatest eGFR inflection point during follow-up. Latent class modeling was applied to identify distinct eGFR trajectories.

RESULTS: At baseline, participants' mean age was 14 years, type 2 diabetes duration was 6 months, mean HbA1c was 6%, and mean eGFR was 120 ml/min/1.73 m

CONCLUSIONS: Distinct eGFR trajectories that associate with albuminuria risk were identified, with the eGFR trajectory characterized by increasing eGFR over time associating with the highest level of albuminuria. These descriptive data support the current recommendations to estimate GFR annually in young persons with type 2 diabetes and provide insight into eGFR-related factors which may contribute to predictive risk strategies for kidney disease therapies in youth with type 2 diabetes.

TRIAL REGISTRATION: clinicaltrials.gov NCT00081328, date registered 2002

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