Comparison of Diabetic Kidney Disease Risk Factors between Normoalbuminuric Reduced and Albuminuric Preserved Kidney Function Groups

The prevalence of normoalbuminuric diabetic kidney disease (NA-DKD) in the U.S. has increased over the past 20 years, and it is higher among patients with good glycemic control. However, the factors associated with NA-DKD remained to be elucidated. Studies have compared NA-DKD with albuminuric DKD (ALB-DKD: ACR ≥ 30 mg/g and eGFR < 60 mL/min/1.73m2); however, ALB-DKD may include cases who have progressed from NA-DKD. Therefore, we aimed to compare DKD risk factors between patients with NA-DKD and those with only albuminuria (only-ALB) status. Among NHANES (1999-2016) adult participants with diagnosed diabetes, we compared DKD risk factors (including demographics) between patients with NA-DKD (ACR < 30 mg/g and eGFR < 60 mL/min/1.73m2) and only-ALB (ACR ≥ 30 mg/g and eGFR ≥ 60 mL/min/1.73m2) using univariate and multivariable analyses. In our diabetes cohort, there were 827 (17.9%) NA-DKD and 923 (16.6%) only-ALB cases. In the multivariable model, diabetes diagnosis age, total cholesterol, HOMA-IR, CRP, and serum uric acid were not significantly associated with albuminuric status, while blood pressure control was the strongest predictor followed by gender [Table]. Future studies should characterize pathways separate from hyperglycemia and elevated BP which contribute to NA-DKD. Disclosure M.Mosslemi: None. T.Costacou: None.