Soluble RAGE further stratifies risk of coronary artery and end-stage kidney disease in high-risk individuals with type 1 diabetes and treatment-resistant hypertension
Authors' conclusion
Elevated sRAGE is associated with increased odds of TRH in individuals with type 1 diabetes. sRAGE further stratifies high risk of incident CAD and ESKD, even after accounting for clinical variables. Along with eGFR, sRAGE may help to identify individuals at the highest risk of adverse cardiovascular and kidney outcomes.
Study context
- Population
- Adults with T1D on antihypertensive therapy with baseline sRAGE measured, FinnDiane study; prospective analyses in those with baseline treatment-resistant hypertension (TRH)
- Participants
- 1,262 adults
- Exposure
- Baseline sRAGE concentration and blood pressure (BP) control status
- Controlled BPn = 295
- Uncontrolled BPn = 730
- TRHn = 237
- Outcome
- Odds of TRH per 100-unit increase in baseline sRAGE
- Follow-up
- Baseline
Methodological detailscompeting risk analysis
- Competing risk analysis
Main finding
As reported in the abstract
- Associations attenuated after adjusting for kidney markers
- TRH vs Uncontrolled BP: P = 0.003
- TRH vs Controlled BP: P = 0.0006
Observational data: associations, not effects.
Further findings
Incident coronary artery disease (CAD) with higher sRAGE in TRH (competing risk) · median follow-up 12 years
- SHR
- 1.05, P = 0.01
- SHR after adjusting for eGFR
- 1.04, P = 0.052
- 62 developed CAD
Incident stroke in TRH · median follow-up 12 years
- sRAGE was not associated with stroke
- 38 stroke
Progression to end-stage kidney disease (ESKD) with higher sRAGE in TRH · median follow-up 9.2 years
- SHR
- 1.06, P < 0.0001
- After adjusting for eGFR: no longer associated
- P = 0.4
- 99 progressed to ESKD
Original publication
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