Progression of Albumin/Creatinine Ratio (ACR) and Estimated Glomerular Filtration Rate (EGFR) over 24 Years in People with T2D—Drivers and Protectors

Introduction and Objective: The pathophysiology of chronic kidney disease (CKD) and type-2 diabetes (T2D) is multifactorial Methods: We examined development of ACR/eGFR over the span of 24years (2001-2024) in a sample of 718 individuals, T2D diagnosed. Longitudinal modelling was conducted to examine rate change of ACR/eGFR over time and how specific factors influenced this in both total sample and 3 subsamples (no-CKD, CKD-increased ACR/preserved eGFR, and CKD-increased ACR/low eGFR). Results: ACR increased exponentially by 0.91mg/mmol per year, while eGFR decreased linearly by 1.02mL/min/1.73m2 per year (Figure). For ACR: SBP (β=0.36, 95% CI [0.24, 0.48]) and DBP were the only significant predictors of ACR progression particularly in the CKD group with increased ACR/preserved eGFR. For eGFR: Female sex, SBP (β=-0.12, 95% CI [-0.17, -0.06]), DBP, HbA1c (β=-1.17, 95% CI [-0.63, -1.71]), baseline cholesterol (β=0.86, 95% CI [0.29, 1.43]), & smoking (β=-2.05, 95% CI [-3.80, -1.30]) were significant predictors of eGFR decline but only in non-CKD at baseline subsample. Conclusion: This study revealed several factors that associate with progression of CKD over 20+years, including female sex and current/previous smoking and higher BP. This highlights the importance of timely risk profiling and intervention, to prevent/reduce the degree of renal complications. Disclosure: A. Matheou: None. O. Zavlis: None. A.C. Lay: None. L.H. Wilkins: None. J.M. Gibson: None. P. Kalra: Speaker's Bureau; Pharmacosmos. Advisory Panel; Medice, CSL Vifor. A.H. Heald: None.