Skip Navigation
Skip to contents

Diabetes Metab J : Diabetes & Metabolism Journal

Search
OPEN ACCESS

Articles

Page Path
HOME > Diabetes Metab J > Volume 44(1); 2020 > Article
Response
Response: Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function (Diabetes Metab J 2019;43:840–53)
Da Hea Seo, So Hun Kim, Moonsuk Namorcid
Diabetes & Metabolism Journal 2020;44(1):205-206.
DOI: https://doi.org/10.4093/dmj.2020.0025
Published online: February 21, 2020
  • 2,941 Views
  • 57 Download
  • 1 Crossref
  • 1 Scopus

Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea.

Corresponding author: Moonsuk Nam. Department of Endocrinology and Metabolism, Inha University School of Medicine, 100 Inha-ro, Nam-gu, Incheon 22212, Korea. namms@inha.ac.kr

Copyright © 2020 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

See the Original "Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function" on page 840.
We appreciate your interest and comments on our article entitled “Presence of carotid plaque is associated with rapid renal function decline in patients with type 2 diabetes mellitus and normal renal function” that was published in Diabetes & Metabolism Journal [1]. You pointed out the importance of age and duration of diabetes in the progression of diabetic kidney disease (DKD). Also, you provided evidences to support that DKD and atherosclerosis share similar risk factors such as inflammation.
We want to emphasize that the ultimate goal of the study was to find means to identify patients with rapid renal function early—when renal function is normal—so interventions can be undertaken to stop or slow the decline. This study focused on the association between baseline carotid atherosclerosis and early rapid renal function decline during a 6-year follow-up in a cohort of patients with type 2 diabetes mellitus (T2DM) and baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2. Although age is one of the important factors for eGFR decline in patients with DKD, age-related loss of kidney function is mainly due to other important comorbidities, such as diabetes and hypertension [23]. Moreover, we defined rapid decline in eGFR as those who had an eGFR decline >3.3% per year, in accordance with previous studies [45]; this threshold corresponds approximately to an eGFR loss ≥2.5 mL/min/1.73 m2 per year, which reflects approximately three times more rapid decline than expected by normal aging [6]. As for the duration of diabetes, previous studies demonstrated that duration of diabetes is not associated with rapid renal function decline in patients with T2DM and preserved renal function decline after adjustment of clinical risk factors [178].
We agree that it would have better reflected renal outcome if we had included temporal changes in carotid intima-media thickness or glycosylated hemoglobin over time instead of cross-sectional baseline parameters. Further prospective trials are warranted to examine the beneficial effects of intensive medical treatment or an improvement in glycemic control and carotid atherosclerosis on prevention or delay of rapid renal function decline in patients with T2DM and preserved renal function. Nevertheless, our study clearly demonstrates that rapid renal function decline in patients with T2DM is associated with carotid atherosclerosis at baseline.

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

  • 1. Seo DH, Kim SH, Song JH, Hong S, Suh YJ, Ahn SH, Woo JT, Baik SH, Park Y, Lee KW, Kim YS, Nam M. KNDP Study Group. Presence of carotid plaque is associated with rapid renal function decline in patients with type 2 diabetes mellitus and normal renal function. Diabetes Metab J 2019;43:840-853. ArticlePubMedPMCPDF
  • 2. Yokoyama H, Tomonaga O, Hirayama M, Ishii A, Takeda M, Babazono T, Ujihara U, Takahashi C, Omori Y. Predictors of the progression of diabetic nephropathy and the beneficial effect of angiotensin-converting enzyme inhibitors in NIDDM patients. Diabetologia 1997;40:405-411. ArticlePubMedPDF
  • 3. Cheng SS, Wilson DM, Munn SR. Predictors of progression of diabetic nephropathy: implication for timing of kidney transplantation. Clin Transplant 1997;11:334-336. PubMed
  • 4. Krolewski AS. Progressive renal decline: the new paradigm of diabetic nephropathy in type 1 diabetes. Diabetes Care 2015;38:954-962. ArticlePubMedPMCPDF
  • 5. Pavkov ME, Knowler WC, Lemley KV, Mason CC, Myers BD, Nelson RG. Early renal function decline in type 2 diabetes. Clin J Am Soc Nephrol 2012;7:78-84. ArticlePubMed
  • 6. Lindeman RD, Tobin J, Shock NW. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 1985;33:278-285. ArticlePubMed
  • 7. Zoppini G, Targher G, Chonchol M, Ortalda V, Negri C, Stoico V, Bonora E. Predictors of estimated GFR decline in patients with type 2 diabetes and preserved kidney function. Clin J Am Soc Nephrol 2012;7:401-408. ArticlePubMed
  • 8. Jiang G, Luk AOY, Tam CHT, Xie F, Carstensen B, Lau ESH, Lim CKP, Lee HM, Ng ACW, Ng MCY, Ozaki R, Kong APS, Chow CC, Yang X, Lan HY, Tsui SKW, Fan X, Szeto CC, So WY, Chan JCN, Ma RCW. Hong Kong Diabetes Register TRS Study Group. Progression of diabetic kidney disease and trajectory of kidney function decline in Chinese patients with type 2 diabetes. Kidney Int 2019;95:178-187. ArticlePubMed

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Mitochondrial DNA and Inflammation Are Associated with Cerebral Vessel Remodeling and Early Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus
      Ligia Petrica, Florica Gadalean, Danina Mirela Muntean, Dragos Catalin Jianu, Daliborca Vlad, Victor Dumitrascu, Flaviu Bob, Oana Milas, Anca Suteanu-Simulescu, Mihaela Glavan, Sorin Ursoniu, Lavinia Balint, Maria Mogos-Stefan, Silvia Ienciu, Octavian Mar
      Biomolecules.2024; 14(4): 499.     CrossRef

    • PubReader PubReader
    • Cite
      CITE
      export Copy
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Response: Presence of Carotid Plaque Is Associated with Rapid Renal Function Decline in Patients with Type 2 Diabetes Mellitus and Normal Renal Function (Diabetes Metab J 2019;43:840–53)
      Diabetes Metab J. 2020;44(1):205-206.   Published online February 21, 2020
      Close
    • XML DownloadXML Download
    Related articles

    Diabetes Metab J : Diabetes & Metabolism Journal