Abstract
Introduction: The kidney disease index (KDI), a novel index combining estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio (UACR), has been proposed as a potential clinical tool for accurately assessing kidney function. This may aid in the better prediction of cardiovascular events in type 2 diabetes mellitus (DM) patients.
Objectives: This study aims to investigate the mean value of the KDI and to evaluate the association between KDI, clinical, and paraclinical factors, and the 10-year cardiovascular risk in type 2 diabetes patients.
Patients and Methods: A cross-sectional descriptive study was conducted on 87 individuals (42 males and 45 females) diagnosed with type 2 DM. Fasting blood samples were taken to measure fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), blood lipid profile, creatinine, and cystatin C levels. Spot urine samples were collected to assess urinary albumin, creatinine, and UACR. The eGFR values were calculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine-Cystatin C equation. KDI was calculated as the geometric mean of 1/eGFR and the natural logarithmic transformation of (100×UACR). Traditional cardiovascular disease risk factors were included in calculating the 10-year cardiovascular risk, based on the Framingham risk score.
Results: The results show that the mean value of KDI was 0.54±0.28. Independently associated factors with KDI were age (P=0.044), duration of DM (P< 0.001), high-density lipoprotein cholesterol (HDL-c) (P=0.008), and HbA1c (P= 0.001). The correlation between the 10-year cardiovascular disease risk, as determined by the Framingham risk score, and KDI (r = 0.294, P=0.024) was stronger than that of eGFR (r = -0.257, P=0.049) but not UACR (r = 0.182, P=0.168).
Conclusion: Adhering to recommendations for screening kidney function and injury in type 2 DM patients who are of advanced age, have a long duration of DM, have low plasma HDL-c levels, and high HbA1c levels is crucial. The potential inclusion of KDI in the prognostic models for adverse events, particularly cardiovascular disease and mortality, may provide additional insight alongside routine tests such as eGFR and UACR.