Association between endothelial dysfunction estimated by flow-mediated dilation and progression of diabetic nephropathy in patients with type 2 diabetes mellitus: data from the Brazilian Diabetes Study

• Grant number: 22/04818-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2022
• End date: October 31, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Andrei Carvalho Sposito
• Grantee: Maria Luíza Rodrigues e Almeida
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Context: The increasing prevalence of patients with type 2 diabetes mellitus (DM2) and diabetic nephropathy (DN) evolving with important cardiovascular and renal outcomes makes it imperative to understand how the incidence and progression of these composite outcomes occurs, and if it is possible to predict them. Although endothelial dysfunction (ED) is present in the pathogenesis and progression of DN, its implications for renal dysfunction in DM2 remain unexplored. The flow-mediated dilation (FMD) test, an estimator of endothelial function, is effective in determining the degree of ED in patients with DM2, who are more prone to a proatherogenic process in the vascular wall.Objective: To assess whether FMD is a risk marker for DN progression.Material and methods: Subanalysis based on data generated by the national, prospective and multicentric cohort of patients with DM2, BDS (Brazilian Diabetes Study). Casuistry: patients between 40 and 70 years old, with diagnosed DM2, followed up since June 2018 by the Laboratory of Atherosclerosis and Vascular Biology (Aterolab) of the State University of Campinas (Unicamp). Procedures: estimation of renal function (through eGFR and degrees of albuminuria) and %FMD. Primary composite outcome: incidence of renal dysfunction and progression of DN. Secondary outcomes: annualized rate of decline in GFR and prevalence of rapid decliners (annualized rate of decline in eGFR >5mL/min/1.73m2/year).