{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T19:37:38Z","timestamp":1770233858188,"version":"3.49.0"},"reference-count":0,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Nephrol"],"published-print":{"date-parts":[[2019]]},"abstract":"<b><i>Background:<\/i><\/b> Overt albuminuria (urinary albumin-creatinine ratio [ACR] &#x3e; 300 mg\/g) is an established risk factor for progression of nephropathy and total mortality. However, whether a reduction in ACR translates into a reduction in mortality and\/or cardiovascular (CV) events among insulin-treated patients with type 2 diabetes (T2D) in routine practice is currently not known. <b><i>Methods:<\/i><\/b> We obtained data on a large cohort of insulin users with T2D and nephropathy (baseline ACR \u2265300 mg\/g) from UK general practices between 2007 and 2014. Their corresponding ACR values after\u00a01year of follow-up were thereafter categorized into: (1) &#x3c;\u00a0300 mg\/g (i.e., albuminuria regression) or (2) &#x3e; 300 mg\/g (i.e., nonregression of albuminuria), and the cohort was followed-up for 5 years for all-cause mortality and CV events. Cox proportional hazard models were fitted to estimate the risk of all-cause death. <b><i>Results:<\/i><\/b> A total of 11,074 patients with insulin-treated T2D met the inclusion criteria. Their mean age was 62.3 (13.6) years; mean HbA1c: 8.7 (1.8) and 53% were male. A total of 682 deaths occurred after a follow-up period of 43,393 person-years with a mortality rate of 16 per 1,000 person-years. Five-year survival was markedly reduced in the group whose proteinuria persisted or progressed (91 vs. 95%; log-rank <i>p<\/i> value &#x3c; 0.001). Compared to patients whose ACR levels remained above 300 mg\/g, all-cause mortality and CV events were 31 and 27% lower in those whose albuminuria regressed to &#x3c; 300 mg\/g (adjusted hazard ratio [aHR] 0.69; 95% CI 0.52\u20130.91; <i>p<\/i> = 0.008 and aHR 0. 73; 95% CI 0.54\u20130.98; <i>p<\/i> = 0.041), respectively. <b><i>Conclusion:<\/i><\/b> In patients with insulin-treated T2D and nephropathy in routine practice, a regression in albuminuria (e.g., via better BP or glycemic control) is associated with a significant reduction in all-cause mortality. Thus, albuminuria is not only simply a risk marker of renal and CV disease but also an independent target for therapy. Albuminuria reduction should be viewed as a goal for renal and CV protection.<\/jats:p>","DOI":"10.1159\/000496276","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T22:03:50Z","timestamp":1548367430000},"page":"146-155","source":"Crossref","is-referenced-by-count":16,"title":["Albuminuria Regression and All-Cause Mortality among Insulin-Treated Patients with Type 2 Diabetes: Analysis of a Large UK Primary Care Cohort"],"prefix":"10.1159","volume":"49","author":[{"given":"Uchenna","family":"Anyanwagu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Donnelly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iskandar","family":"Idris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2019,1,24]]},"container-title":["American Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/496276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/496276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:23:42Z","timestamp":1745429022000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000496276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,13]]}},"URL":"https:\/\/doi.org\/10.1159\/000496276","archive":["Portico"],"relation":{},"ISSN":["0250-8095","1421-9670"],"issn-type":[{"value":"0250-8095","type":"print"},{"value":"1421-9670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019]]}}}