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Updated: Mar 31, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

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Worsening Kidney Function and Cardiovascular Outcomes in Type 2 Diabetes and Atherosclerotic Disease

Abhinav Sharma1, Amir Razaghizad1, Susanna R Stevens2

  • 1DREAM-CV Lab, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.

JACC. Advances
|March 30, 2026
PubMed

Insights

Worsening kidney function (WKF) is common in type 2 diabetes (T2D) patients with cardiovascular disease and increases risks for major adverse cardiovascular events (MACE4) and severe hypoglycemia.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • The relationship between worsening kidney function (WKF) and cardiovascular outcomes in patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD) requires further elucidation.
  • Understanding this bidirectional association is crucial for managing T2D patients with existing ASCVD.

Purpose of the Study:

  • To investigate the association between nonfatal cardiovascular events and WKF in T2D patients with ASCVD.
  • To evaluate the link between severe hypoglycemia and WKF in this patient population.

Main Methods:

  • Analysis of data from the TECOS trial, including 14,671 patients with T2D and ASCVD.
  • Primary outcome: 4-component major adverse cardiovascular event (MACE4). Secondary outcome: hospitalization for heart failure (hHF).
  • WKF defined as ≥40% glomerular filtration rate decline or renal replacement therapy initiation; Cox proportional hazards models used.

Main Results:

  • Worsening kidney function (WKF) occurred in 7.0% of patients over a median 3-year follow-up.
  • WKF risk was elevated following nonfatal myocardial infarction, stroke, unstable angina, and particularly after hospitalization for heart failure (hHF).
  • WKF was significantly associated with increased risks of MACE4, hHF, and severe hypoglycemia.

Conclusions:

  • Worsening kidney function (WKF) is a prevalent issue in patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD).
  • WKF is strongly linked to adverse cardiovascular outcomes and severe hypoglycemia.
  • Early implementation of cardiorenal therapies is recommended for this high-risk group.
Abstract

Keywords:
cardiovascular diseasechronic kidney diseaseheart failuretype 2 diabetes

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