Impaired Fasting Glucose and Chronic Kidney Disease, Albuminuria, or Worsening Kidney Function: a Secondary Analysis of the SPRINT.
Abstract
PURPOSE
Diabetes mellitus is a risk factor for the development and progression of chronic kidney disease (CKD). However, the association of prediabetes with adverse kidney outcomes is uncertain.
METHODS
We performed a secondary analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), including 9,361 participants without diabetes at baseline. We categorized participants according to fasting glucose as having impaired fasting glucose (≥100 mg/dL [(≥5.6 mmol/L]) or normoglycemia (10 mg/g). These outcomes were also evaluated separately, and according to CKD status at baseline.
RESULTS
The mean age was 67.9 ± 9.4 years, 35.5% were female, and 31.4% were black. The median follow-up was 3.3 years and 41.8% had impaired fasting glucose. Impaired fasting glucose was not associated with higher rates of the composite outcome (HR 0.97; 95%CI 0.81-1.16), worsening kidney function (HR 1.02; 95%CI 0.75-1.37), or albuminuria (HR 0.98; 95%CI 0.78-1.23). Similarly, there was no association of impaired fasting glucose with outcomes according to baseline CKD status.
CONCLUSIONS
Impaired fasting glucose at baseline was not associated with the development of worsening kidney function or albuminuria in participants of SPRINT.
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 9,361 participants or records.
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