Table 2.
Effects of intensive glycemic control, BP control, and fenofibrate on long-term kidney outcomes in 10,139 participants of the ACCORD study
| Outcome | Intensive Glycemic Control | Intensive BP Control | Fenofibrate Treatment | ||||||
|---|---|---|---|---|---|---|---|---|---|
| n=10,139 (5074 Intensive; 5065 Standard) | n=4682 (2345 Intensive; 2337 Standard) | n=5457 (2736 Fibrate; 2721 Placebo) | |||||||
| Event Number | Univariable HR/SHR (95% CI) | Multivariablea HR/SHR (95% CI) | Event Number | Univariable HR/SHR (95% CI) | Multivariablea HR/SHR (95% CI) | Event Number | Univariable HR/SHR (95% CI) | Multivariablea HR/SHR (95% CI) | |
| Composite kidney outcome | 1652 Int 1759 Std | 0.92 (0.86 to 0.99)d | 0.92 (0.86 to 0.98)d | 780 Int 721 Std | 1.15 (1.04 to 1.23)d | 1.16 (1.05 to 1.28)d | 1007 Feno 903 Plac | 1.15 (1.05 to 1.26)d | 1.16 (1.06 to 1.27)d |
| Macroalbuminuriab,c | 421 Int 567 Std | 0.72 (0.64 to 0.82)d | 0.68 (0.59 to 0.77)d | 212 Int 219 Std | 1.00 (0.83 to 1.21) | 0.97 (0.79 to 1.17) | 304 Feno 253 Plac | 1.19 (1.00 to 1.40) | 1.11 (0.93 to 1.33) |
| Doubling of creatininec | 490 Int 464 Std | 1.05 (0.93 to 1.20) | 1.09 (0.94 to 1.23) | 245 Int 170 Std | 1.52 (1.25 to 1.85)d | 1.64 (1.30 to 2.06)d | 344 Feno 195 Plac | 1.83 (1.54 to 2.18)d | 2.00 (1.61 to 2.49)d |
| Dialysisc | 161 Int 190 Std | 0.84 (0.68 to 1.04) | 0.92 (0.72 to 1.16) | 72 Int 81 Std | 0.91 (0.67 to 1.25) | 0.90 (0.63 to 1.28) | 98 Feno 100 Plac | 0.97 (0.74 to 1.29) | 1.09 (0.80 to 1.50) |
| All-cause mortality | 952 Int 953 Std | 1.00 (0.92 to 1.09) | 1.00 (0.91 to 1.10) | 406 Int 403 Std | 1.03 (0.90 to 1.18) | 1.01 (0.88 to 1.17) | 537 Feno 559 Plac | 0.95 (0.84 to 1.06) | 0.96 (0.85 to 1.08) |
ACCORD, Action to Control Cardiovascular Risk in Diabetes; HR, hazard ratio; SHR, subhazard ratio; 95% CI, 95% confidence interval; Int, intensive; Std, standard; Feno, fenofibrate; Plac, placebo.
Multivariable analyses are adjusted for: baseline age, sex, ethnicity, study site, randomization to tight BP group, randomization to fenofibrate group, previous cardiovascular event, eGFR, urine albumin-to-creatinine ratio, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, hemoglobin A1c, and systolic BP.
Denominators for macroalbuminuria outcome: 4410 intensive glycemic, 4431 standard glycemic; 2065 intensive BP, 2040 standard BP; 2388 fenofibrate, 2348 placebo.
Models for nonfatal components of the composite outcome include death as a competing risk.
Statistically significant results.