Glomerular Filtration Rate (GFR) Decline Predicts Total Mortality and Mediates the Effect of Tryptophan Metabolism on Death Risk in Type 2 Diabetes
Authors' conclusion
In patients with type 2 diabetes, eGFR decline is independently associated with the risk of all-cause mortality and mediates a significant proportion of the association between tryptophan metabolism and death.
Study context
- Population
- Patients with T2D with ≥3 eGFR recordings and ≥1.5 years of follow-up (Gargano Mortality Study)
- Participants
- 962 patients
- Outcome
- All-cause mortality in relation to eGFR change over time
- Follow-up
- Average 14.8 years
Methodological detailsobservational, single research hospital
- Observational
- Single research hospital
Main finding
As reported in the abstract
Age- and sex-adjusted annual incident rate of mortality
2.75 events per 100 person-years
Median annual rate of eGFR decline (range −3.7; 7.8)
1.3 mL/min per 1.73 m² per year
Observational data: associations, not effects.
Further findings
Serum kynurenine to tryptophan ratio (KTR), eGFR decline and mortality
- Proportion of KTR–mortality association mediated by eGFR decline (causal mediation analysis)
- 24.3%
- KTR associated with both eGFR decline and all-cause mortality
Original publication
GFR Decline Predicts Total Mortality and Mediates the Effect of Tryptophan Metabolism on Death Risk in Type 2 Diabetes. J Clin Endocrinol Metab. Published 13 August 2024. doi:10.
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