Incident heart failure and the subsequent risk of progression to end stage kidney disease in individuals with type 2 diabetes
Main finding · Incident ESKDResult — go to the resultFold increased risk (Cox regression) 9.6 95% CI 5.0–18.3Authors' conclusion
Incident heart failure impinges a high risk for progression to ESKD in individuals with type 2 diabetes. Our data highlight the need for intensive surveillance of kidney function after incident heart failure, especially within the first two years after heart failure diagnosis.
Study context
- Population
- Asian outpatients with T2D from a regional hospital and a primary care facility in Singapore
- Participants
- 1,985 outpatients
- Exposure
- Incident HF vs no HF event
- Outcome
- ESKD: composite of progression to sustained eGFR below 15 ml/min/1.73m2, maintenance dialysis or renal death, whichever occurred first
- Follow-up
- Median 8.6 (IQR 6.2-9.6) years
Main finding
Incident ESKD
Fold increased risk (Cox regression)
9.6
95% CI 5.0–18.3
As reported in the abstract
- Incident HF events
- 180
- Incident end stage kidney disease (ESKD) events
- 181
- ESKD events occurring after incident HF
- 38 (21%)
Observational data: associations, not effects.
Further findings
ESKD risk by HF type: HF with preserved vs reduced ejection fraction
- Adjusted HR, HF with preserved ejection fraction
- 13.7 [6.3-29.5]
- Adjusted HR, HF with reduced ejection fraction
- 6.5 [2.3-18.6]
Timing of excess ESKD risk after HF
- Excess risk of ESKD manifested immediately after HF occurrence, persisted for two years and was moderated thereafter
Characteristics of those progressing to ESKD after HF vs not (n = 142) · baseline
- Those who progressed to ESKD after HF were younger, had higher HbA1c and higher urine albumin-to-creatinine ratio at baseline
Original publication
Incident heart failure and the subsequent risk of progression to end stage kidney disease in individuals with type 2 diabetes. Cardiovasc Diabetol. Published 15 June 2024. doi:10.
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