Association of Serum Concentration of TNFR1 With All-Cause Mortality in Patients With Type 2 Diabetes and Chronic Kidney Disease: Follow-up of the SURDIAGENE Cohort DOI: 10.2337/dc13-2580 OBJECTIVE

Renal dysfunction is a key risk factor for all-cause mortality in patients with type 2 diabetes (T2D). Circulating tumor necrosis factor receptor 1 (TNFR1) was re-cently suggested as a strong biomarker for end-stage renal failure in T2D. How-ever, its relevance regarding all-cause death has yet to be conclusively established. We aimed to assess the prognostic value of serum TNFR1 concen-tration for all-cause death in T2D and diabetic kidney disease (DKD) from the SURDIAGENE (Survie, Diabete de type 2 et Genetique) study. RESEARCH DESIGN AND METHODS A total of 522 T2D patients with DKD (estimated glomerular filtration rate [eGFR] <60 and/or urinary albumin-to-creatinine ratio [uACR]>30 mg/mmol) were fol-lowed for a median duration of 48 months, and 196 deaths occurred. RESULTS Incidence rate (95 % CI) for death increased as quartiles of TNFR1 concentration increased (first quartile: 4.7 % patient-years [3.0–6.3%]; second quartile: 7.7% [5.4–10.0%]; third quartile: 9.3 % [6.7–11.9%]; fourth quartile: 15.9 % [12.2