Association between atherosclerosis and newly classified chronic kidney disease stage for Japanese patients with type 2 diabetes

Using a new estimated glomerular filtration rate (eGFR) equation, we undertook a retrospective chart review to investigate the clinical significance of chronic kidney disease (CKD) stage for atherosclerosis in 653 Japanese patients with type 2 diabetes that were followed from January 2004 to December 2006 at Juntendo University Hospital. Diabetic patients with CKD stage 2 or 3 detected in 2004 or before had more history of cardiovascular disease (CVD) compared with those patients without CKD [ischemic heart disease (IHD): 25% vs. 9.3%, P < 0.01 and stroke: 17.6% vs. 10.5%, P < 0.05]. In Addition, the incidence of CVD through the observation period tended to increase with progression of CKD stage (0.9% in stage 0, 3.2% in stage 1 or 2, and 3.4% in stage ≥3, P = 0.056), and patients with eGFR < 75 had a higher incidence of IHD (2.5% vs. 0.3%) and IHD or Stroke (3.3% vs. 0.7%) compared with those who had eGFR ≥75. Patients with urinary albumin excretion rate (UACR) ≥20 mg/g Cr also had a higher incidence of IHD or stroke compared to patients with UACR < 20 (3.5% vs. 0.6%). In conclusion, diabetic patients with eGFR < 75 and/or UACR ≥20 might be a high-risk population for CVD.