The relationship between eGFR and hospitalization for heart failure in 54,486 individuals with type 2 diabetes
Journal article, 2016

BACKGROUND: To study the association between renal function and hospitalization for heart failure (HF) in individuals with type 2 diabetes. METHODS: Renal function was determined according to 3 formulas used to estimate glomerular filtration rate (eGFR): Cockcroft-Gault, Modified Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology (CKD-EPI). Proportional hazards regression models adjusted for age, sex, HbA1c, blood pressure, smoking, and cardiovascular comorbidities were constructed for each eGFR formula to estimate risk of HF hospitalization. RESULTS: In 54,486 patients, using Cockcroft-Gault, 41% were categorized as having normal renal function (eGFR > 90 ml/min), compared to 22.9% using MDRD and 21.6% using CKD-EPI. In the cohort, there were 21%-24% (depending on eGFR formula) with eGFR < 60 ml/min of whom 1.0%-1.5% had eGFR < 30 ml/min. Over a median follow-up of 7.0 years, a total of 5936 (10.9%) developed heart failure, with an excess risk in all eGFR categories below 60 ml/min/1.73 m2 (reference: eGFR > 90 ml/min/1.73 m2). Hazard ratios (HRs) ranged from 1.25 to 1.35 for eGFR 45-60 ml/min/1.73 m2,1.62 to 1.66 for eGFR 30-45 ml/min/1.73 m2, and 2.18 to 2.52 for eGFR <30 ml/min/1.73 m2 in the three eGFR formulas. CONCLUSIONS: Patients with type 2 diabetes, with eGFR 45 to 60 ml/min/1.73 m2 , have approximately 25%-35% increased risk of hospitalization for HF, increasing with lower eGFR, to 2-2.5 times in those with eGFR <30 ml/min/1.73 m2.

type 2 diabetes mellitus


chronic kidney disease

heart failure

glomerular filtration rate



M. Tancredi

University of Gothenburg

Annika Rosengren

University of Gothenburg

Marita Olsson

University of Gothenburg

Chalmers, Mathematical Sciences, Mathematical Statistics

Soffia Gudbjörnsdottir

University of Gothenburg

A. M. Svensson

Region Västra Götaland

B. Haraldsson

University of Gothenburg

Marcus Lind

University of Gothenburg

Diabetes/Metabolism Research and Reviews

1520-7552 (ISSN) 1520-7560 (eISSN)

Vol. 32 7 730-735

Subject Categories

Clinical Medicine





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