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Albuminuria in Type 2 Diabetes and Risk of Cardiorenal Outcomes
Saaima Parveen1, Morten Malmborg1, Anojhaan Arulmurugananthavadivel1
1Department of Cardiology, Copenhagen University, Hospital Herlev and Gentofte, Copenhagen, Denmark.
JACC. Advances
|October 24, 2025
Summary
Forty percent of patients with type 2 diabetes (T2D) have albuminuria, increasing cardiorenal risks. Even without albuminuria, patients face significant cardiovascular disease risks, necessitating focused attention and potential treatment.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Albuminuria is a known risk factor for cardiorenal complications.
- Real-world data on albuminuria prevalence and associated risks in type 2 diabetes (T2D) are limited.
Purpose of the Study:
- To determine the prevalence of albuminuria in patients with T2D.
- To assess the cardiorenal outcomes associated with albuminuria in T2D.
- To evaluate treatment eligibility for cardiovascular and renoprotective drugs.
Main Methods:
- Utilized Danish nationwide registers to identify T2D patients with measured UACR and creatinine.
- Categorized patients into albuminuria (UACR ≥30 mg/g) and normoalbuminuria (UACR <30 mg/g) groups.
- Analyzed 4-year risks of composite cardiorenal outcomes (heart failure, MI, stroke, death, ESRD, eGFR decline).
Main Results:
- Included 74,014 T2D patients; 40% had albuminuria.
- Albuminuria group showed longer diabetes duration, lower eGFR, and higher male representation.
- Absolute 4-year risks were significantly higher for primary (28.6% vs 18.7%) and secondary (8.7% vs 2.9%) outcomes in albuminuria vs normoalbuminuria groups.
Conclusions:
- Albuminuria affects 40% of T2D patients, indicating potential benefit from cardiovascular and renoprotective therapies.
- A significant residual risk of cardiovascular disease exists in the 60% of T2D patients with normoalbuminuria, requiring increased clinical focus.
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