Risk Of New-onset Diabetes Research Articles

Alcohol Consumption and Risk of Type 2 Diabetes Mellitus—A Nationwide Cohort Study

Background and Aims: Alcohol consumption correlates with type 2 diabetes through its effects on insulin resistance, changes in alcohol metabolite levels, and anti-inflammatory effects. We aim to clarify association between alcohol consumption and risk of diabetes in Taiwanese population. Methods: The National Health Interview Survey (NHIS) in 2001, 2005, and 2009 selected a representative sample of Taiwan population using a multistage sampling design. Information was collected by standardized face to face interview. Study subjects were connected to the Taiwan National Health Insurance claims dataset and National Register of Deaths Dataset from 2000 to 2013. Kaplan-Meier curve with log rank test was employed to assess the influence of alcohol drinking on incidence of diabetes. Univariate and multivariate Cox proportional regression were used to recognize risk factors of diabetes. Results: A total of 43,000 participants were included (49.65% male; mean age, 41.79±16.31 years). During the 9-year follow-up period, 3,650 incident diabetes cases were recognized. Kaplan-Meier curves comparing the four groups of alcohol consumption showed significant differences (p<0.01). After adjustment for potentially confounding variables, compared to social drinkers, the risks of diabetes were significantly higher for non-drinkers (adjusted hazard ratio [AHR]=1.21; 95% confidence interval [CI], 1.09-1.34; p<0.01), regular drinkers (AHR=1.19; 95% CI, 1.06-1.35; p <0.01), and heavy drinkers (AHR=2.21, 95% CI, 1.56-3.13, p<0.01). Conclusions: Social drinkers have a significantly decreased risk of new-onset diabetes compared with non-, regular, and heavy drinkers. Disclosure Y. Lai: None.

Risk of new-onset diabetes among patients treated with statins according to hypertension and gender: Results from a nationwide health-screening cohort.

BackgroundStatins have been known to increase the risk of incident type 2 diabetes mellitus (DM); however, other factors, especially hypertension, are also associated with DM development.ObjectiveWe investigated whether statin use increases the risk of DM and further analyzed whether the relation between statin use and incident DM differs according to the presence of hypertension and gender.MethodsFrom a nationwide health-screening cohort, 40,164 participants with total cholesterol levels ≥eve mg/dL and without pre-diagnosed DM, cardiovascular disease, or cancer, who underwent a series of regular health check-ups, were enrolled. Statin users were defined as participants who were prescribed statins more than twice during 6 months.ResultsThere were 17,798 statin non-users and 22,366 statin users. During 7.66±3.21 years of follow-up, incident DM developed in 5.68% of statin non-users and 7.64% of statin users. Among the entire study population, statin use was associated with new-onset DM after adjusting for clinical risk factors. In sub-analysis according to hypertension, statin use significantly increased the risk of incident DM only in normotensive patients [hazard ratio (HR) 1.31, 95% confidence interval (CI) 1.09 to 1.58, p = 0.004], and not in hypertensive patients (p>0.05). Furthermore, continuous statin use was strongly associated with new-onset DM in women, regardless of hypertension presence (all p<0.05). However, in men, statin was associated with new-onset DM only in normotensive males (HR 1.61, 95% CI 1.35 to 1.92, p<0.001) and not in hypertensive males (p>0.05).ConclusionsStatin use increased the risk of new-onset DM only in normotensive patients and hypertensive women, suggesting that these groups should be more carefully monitored for the development of DM during the course of follow-up.

Abstract 184: Self-reported Hypertension Treatment Practices Among Primary Care Physicians and Cardiologists

Objectives: This study was conducted to examine perceptions, knowledge, and rationale for prescribing β-blockers among physicians who treat patients with hypertension. Methods: In August/September 2016, 103 primary care physicians (PCPs) and 59 cardiologists participated in a 20-minute quantitative, online survey regarding their use and perceptions of β-blockers. Significant between-group differences were examined via t-tests and z-tests. Results: Significantly more cardiologists chose β-blockers as first-line therapy than PCPs (30% vs 17%, P &lt;0.01). Metoprolol and carvedilol were the most commonly prescribed β-blockers. When choosing a β-blocker, cardiologists rated “impact on fatigue and energy” and “arterial vasodilation” as more important treatment features than PCPs ( P &lt;0.05 and P &lt;0.01, respectively). Physicians’ awareness of vasodilation was greater for carvedilol (52% [84/162]) than nebivolol (31%[51/162]). A large proportion of cardiologists and PCPs were unaware that any β-blockers cause weight gain (cardiologists, 34%[20/59]; PCPs, 39%[40/103]) or increased glucose (42% each, cardiologists [25/59], PCPs [43/103]). Overall, physicians associated atenolol and metoprolol with weight gain and clinically relevant changes in glucose, while nebivolol was least associated with either outcome. Only 10% of cardiologists (6/59) and 2% of PCPs (2/103) associated carvedilol with weight gain ( P &lt;0.05). Among β-blocker features, nebivolol was closely associated with: β 1 -selectivity; efficacy in patients aged &gt;60 years; efficacy in African-American patients; and arterial vasodilation. Metoprolol was closely associated with heart rate reduction, and atenolol was associated with heart rate reduction, fatigue, erectile dysfunction, and impact on mood. Physicians had a positive response to using drugs other than metoprolol or atenolol that could lower the risk of new onset diabetes for pre-diabetic or obese patients. Clinical practice guidelines influenced prescribing behaviors more than formulary or performance metrics; continuing medical education and publications were commonly accessed materials for hypertension education. Conclusions: This survey highlights several educational gaps, including differences between PCPs and cardiologists, on the perceptions of β-blockers for hypertension treatment. Future efforts should include physician education on relevant evidence-based differences between β-blockers, given their heterogeneity.

Association of Body Mass Index and the Risk of New-Onset Diabetes After Kidney Transplantation: A Meta-analysis

ObjectiveTo comprehensively examine the correlation between body mass index (BMI) and the risk of new-onset diabetes after kidney transplantation (NODAT). MethodsThe electronic databases Pubmed, Embase, and Cochrane Library, updated in December 2016, were searched, and a literature review was conducted as well to identify relevant research studies. With the use of R 3.12 software, the association between BMI and NODAT risk was analyzed by means of a meta-analysis, with the mean differences (MDs) and their 95% confidence intervals (CIs) as effect indexes. Publication bias was assessed with the use of the Egger test. A sensitivity analysis was performed by excluding 1 study at a time. And the overall morbidity of NODAT was calculated. ResultsIn the meta-analysis, 55 eligible studies involving 15,458 kidney transplantation cases were included. After the heterogeneity test, the random-effects model was used to calculate the pooled results of the effect indexes. The results of the meta-analysis showed that BMI was an independent risk factor of NODAT (MD, 1.88; 95% CI, 1.48–2.27). No publication bias was found among the included studies (t = 0.3417; P = 0.7339). The sensitivity analysis revealed that the pooled MD did not reverse after ignoring 1 study at a time. In addition, the overall morbidity of NODAT was 21% (95% CI, 21%–23%). ConclusionsOur results suggest that BMI is an independent risk factor for NODAT.

Baseline glucose homeostasis predicts the new onset of diabetes during statin therapy: A retrospective study in real life.

We evaluated the risk of altered glucose levels and new-onset diabetes (NOD) associated with statins according to glucose levels at baseline in a population treated for dyslipidemia on primary prevention for >5 years. The retrospective study included 308 subjects (265 on statins and 43 controls on diet) with a follow-up of 5-15 years. The cohort was classified according to glucose tolerance at both baseline and follow-up. The cumulative incidence of NOD was 13.6% (9.3% in controls and 13.5% in treated patients). NOD was diagnosed after 3.4±1.8 years. In the group with normal glucose levels at baseline, a family history of diabetes (OR: 3.4, 95% CI 1.3-8.9), BMI >30 kg/m2 (OR: 8.5, 95% CI 2.0-35.8), treatment with thiazide (OR: 21.9, 95% CI 1.2-384.2) and no alcohol consumption (OR: 0.3, 95% CI 0.1-0.8) reduced the risk of developing altered glucose levels or NOD. No effects of statins were seen. In the group with altered glucose levels at baseline, hypertension (OR: 5.0, 95% CI 1.0-25.3) and hypertriglyceridemia (OR: 3.5, 95% CI 1.0-11.8) increased the risk of remaining with altered glucose levels or developing NOD. Treatment with statins (OR: 7.5, 95% CI 1.5-37.4), in particular atorvastatin, was associated with an increased risk. In the whole population, statin therapy (OR: 4.0, 95% CI 1.1-14.1, p<0.020), and in particular simvastatin and atorvastatin, was associated with increased risk of altered glucose levels or NOD. Patients who developed or maintained altered glucose levels or NOD had a poor metabolic phenotype at baseline. Statins were associated with an increased risk of NOD or altered glucose levels, mainly in subjects with altered glucose levels before the beginning of therapy. Poor metabolic phenotype and unhealthy behaviors or family history of diabetes contributed to that risk.

The association between Helicobacter pylori seropositivity and risk of new-onset diabetes: a prospective cohort study

Aims/hypothesisPrevious studies have suggested a possible connection between Helicobacter pylori (H. pylori) infection and diabetes risk. However, prospective studies examining direct associations between these two factors are relatively lacking. In this prospective cohort study, we aimed to evaluate the association between H. pylori infection and risk of developing diabetes.MethodsWe performed a population-based prospective study, recruiting participants aged 45–74 years and without diabetes from the Chinese Multi-provincial Cohort Study in 2002, with a 10 year follow-up to investigate development of diabetes. H. pylori serostatus was determined by measuring serum H. pylori antibodies. H. pylori seropositivity was defined as the antibody concentration ≥ 10 U/ml. To examine the association between H. pylori seropositivity and diabetes risk, modified Poisson regression was performed.ResultsOf 2085 participants without diabetes, 1208 (57.9%) were H. pylori seropositive in 2002. After multivariate adjustment of possible diabetes risk factors, H. pylori seropositivity was associated with lower risk of diabetes (RR 0.78 [95% CI 0.63, 0.97], p = 0.022). Of the 1275 participants with H. pylori antibody measurements in both 2002 and 2007, 677 (53.1%) were persistently seropositive. A lower risk of diabetes was also observed in participants with persistent H. pylori seropositivity (RR 0.61 [95% CI 0.41, 0.93], p = 0.020), compared with those persistently seronegative.Conclusions/interpretationH. pylori seropositivity was associated with lower risk of diabetes in this prospective cohort study. Extrapolation of these results and the mechanism underlying the observed association require further investigation.

Statin use and risk of new-onset diabetes: a meta-analysis of observational studies

Abstract Background and aims Meta-analyses of randomized control trials investigating the association between incident diabetes and statin use showed an increased risk of new-onset diabetes (NOD) from 9% to 13% associated with statins. However, short follow-up period, unpowered sample size, and lack of pre-specified diagnostic criteria for diabetes detection could be responsible of an underestimation of this risk. We conducted a meta-analysis of published observational studies to evaluate the association between statins use and risk of NOD. Methods and results PubMed, EMBASE and MEDLINE databases were searched from inception to June 30, 2016 for cohort and case–control studies with risk of NOD in users vs nonusers, on ≥1000 subjects followed-up for ≥1 year. Two review authors assessed study eligibility and risk of bias and undertook data extraction independently. Pooled estimates were calculated by a random-effects model and between-study heterogeneity was tested and measured by I 2 index. Furthermore, stratified analyses and the evaluation of publication bias were performed. Finally, the meta-analysis included 20 studies, 18 cohort and 2 case–control studies. Overall, NOD risk was higher in statin users than nonusers (RR 1.44; 95% CI 1.31–1.58). High between-study heterogeneity (I 2 = 97%) was found. Estimates for all single statins showed a class effect, from rosuvastatin (RR 1.61; 1.30–1.98) to simvastatin (RR 1.38; 1.19–1.61). Conclusions The present meta-analysis confirms and reinforces the evidence of a diabetogenic effect by statins utilization. These observations confirm the need of a rigorous monitoring of patients taking statins, in particular pre-diabetic patients or patients presenting with established risk factors for diabetes.

High serum PCSK9 is associated with increased risk of new-onset diabetes after transplantation in renal transplant recipients

OBJECTIVE New-onset diabetes after transplantation (NODAT) is a major complication in renal transplant recipients (RTRs). Cholesterol metabolism has been linked to diabetes development. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is crucial in LDL receptor regulation. Its association with NODAT is unknown. We prospectively determined the association between serum PCSK9 levels and NODAT development and then with all-cause mortality, cardiovascular mortality, and renal graft failure. RESEARCH DESIGN AND METHODS In a university setting, nondiabetic RTRs recruited between 2001 and 2003 with a functional graft for ≥1 year were eligible. Serum PCSK9 was measured by ELISA. Cox proportional hazards analysis was used to assess the association of PCSK9 with the development of NODAT, all-cause mortality, cardiovascular mortality, and graft failure. RESULTS In 453 RTRs (age 51 ± 12 years, 56% male; 6.1 [2.7–11.7] years after transplantation), serum PCSK9 was 107.1 ± 43.4 μg/L. During a median follow-up of 10 years, 70 RTRs developed NODAT, 123 died, and 59 developed graft failure. NODAT occurred more frequently in the upper PCSK9 tertile (23%) versus the lowest two PCSK9 tertiles (12%; P CONCLUSIONS Circulating PCSK9 is associated with NODAT in RTRs. The PCSK9 pathway may contribute to the pathogenesis of NODAT.

Lipid levels and new-onset diabetes in a hypertensive population: the China Stroke Primary Prevention Trial

This study aimed to provide insights into the relationship between lipid levels and new-onset diabetes (NOD) in 14,864 Chinese hypertensive patients without diabetes (6056 men and 8808 women) aged 45–75 years from the China Stroke Primary Prevention Trial (CSPPT, led by Nanfang Hospital, Guangzhou, China). NOD (defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L at the end of study or self-reported physician diagnosis of diabetes or self-reported use of hypoglycemic agents during follow-up) was analyzed using multivariate analysis. Follow-up was censored on August 24, 2014. Among the 14,864 subjects, 1615 developed NOD (10.9%, men = 10.8% and women = 10.9%). Increased triglycerides (TG) [odds ratio (OR) = 1.18; 95% confidence interval (CI): 1.13–1.25, P < 0.001], TG/HDL (OR = 1.12; 95%CI: 1.08–1.17, P < 0.001), and decreased high density lipoprotein (HDL) (OR = 0.79; 95%CI: 0.67–0.93, P = 0.005) were associated with NOD, independently from age, gender, body mass index, clinical center, systolic blood pressure, diastolic blood pressure, FPG, smoking, and drinking. Compared to subjects with the methylenetetrahydrofolate reductase (MTHFR) 677 CC and TT genotypes, those with the CT genotype had a higher risk of NOD (OR = 1.54; 95%CI: 1.30–1.81, P for interaction = 0.044) in subjects with high TG. These results suggested that TG and TG/HDL were independent risk factors for NOD in this Chinese hypertensive population. HDL was a protective factor for NOD.

The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis.

BackgroundAntidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes.Methods and findingsA systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical s (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19–1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association.ConclusionsThis updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.

Effect of atorvastatin and rosuvastatin on glucose intolerance in low dose streptozotocin induced hyperglycemic Albino rats

Background: Dyslipidemia and glucose intolerance are closely associated with each other especially as a part of metabolic syndrome. Statins are the drug of choice for treatment of dyslipidemia and for primary prevention of coronary heart disease in diabetics. Recent studies indicate risk of new onset diabetes in patients receiving statins. Hence it was worthwhile to study the effect of two most commonly used statins, which differ in their lipophilicity, on glucose tolerance in prediabetic animal model.Methods: The study consisted of 3 groups with 6 wistar rats in each and hyperglycemia was induced by intraperitoneal injection of low dose (25mg/kg) streptozotocin. Group 1 served as control, group 2 and 3 were given Atorvastatin and Rosuvastatin respectively for 8 weeks. Oral glucose tolerance test (OGTT) was performed at 0,1 and 2 hrs after glucose load on days 0, 14, 28, 42 and 56 days.Results: Starting from 28th day onwards both the treatment groups showed progressive worsening of glucose tolerance throughout the study period in comparison to the control. The impairing effect on glucose tolerance was less pronounced in Rosuvastatin group as compared to Atorvastatin.Conclusions: Hydrophilic Rosuvastatin showing less impairing effect on glucose tolerance can be a rational choice than lipophilic Atorvastatin for prevention and control of dyslipidemia in patients at risk of developing frank diabetes or having impaired glucose tolerance.

Lipid-lowering drugs and risk of new-onset diabetes: a cohort study using Japanese healthcare data linked to clinical data for health screening

ObjectiveTo investigate whether lipid-lowering drugs are associated with new-onset diabetes after adjusting for baseline clinical risk factors for diabetes.DesignA retrospective cohort study.SettingJapanese employees of large corporations and their dependents using...

Statin use and risk of new-onset diabetes: A meta-analysis of observational studies

Background and aimsMeta-analyses of randomized control trials investigating the association between incident diabetes and statin use showed an increased risk of new-onset diabetes (NOD) from 9% to 13% associated with statins. However, short follow-up period, unpowered sample size, and lack of pre-specified diagnostic criteria for diabetes detection could be responsible of an underestimation of this risk. We conducted a meta-analysis of published observational studies to evaluate the association between statins use and risk of NOD. Methods and resultsPubMed, EMBASE and MEDLINE databases were searched from inception to June 30, 2016 for cohort and case–control studies with risk of NOD in users vs nonusers, on ≥1000 subjects followed-up for ≥1 year. Two review authors assessed study eligibility and risk of bias and undertook data extraction independently. Pooled estimates were calculated by a random-effects model and between-study heterogeneity was tested and measured by I2 index. Furthermore, stratified analyses and the evaluation of publication bias were performed. Finally, the meta-analysis included 20 studies, 18 cohort and 2 case–control studies. Overall, NOD risk was higher in statin users than nonusers (RR 1.44; 95% CI 1.31–1.58). High between-study heterogeneity (I2 = 97%) was found. Estimates for all single statins showed a class effect, from rosuvastatin (RR 1.61; 1.30–1.98) to simvastatin (RR 1.38; 1.19–1.61). ConclusionsThe present meta-analysis confirms and reinforces the evidence of a diabetogenic effect by statins utilization. These observations confirm the need of a rigorous monitoring of patients taking statins, in particular pre-diabetic patients or patients presenting with established risk factors for diabetes.

Towards reducing the risk of new onset diabetes after pancreatitis

Metabolic abnormalities due to acute and chronic pancreatitis are common. In particular, post-pancreatitis diabetes mellitus (PPDM) is increasingly recognized as a distinct clinical entity. However, most of the research in this field is focused on unravelling the pathogenesis of PPDM whereas research frontiers are rarely extended to reducing the risk of new onset diabetes after pancreatitis (NODAP). The recent development and validation of the PERSEUS score paved the way to identifying individuals after acute pancreatitis who are at high risk of developing NODAP. This article discusses the PERSEUS score and other evidence that may inform the development of guidelines on reducing the burden of PPDM.

Does coenzyme Q10 play a role in the risk of new-onset diabetes due to statins?

Does coenzyme Q10 play a role in the risk of new-onset diabetes due to statins?

099 - An Evaluation of the Effect of Spironolactone on the Risk of New-Onset Diabetes in a Cohort of Patients with Heart Failure

099 - An Evaluation of the Effect of Spironolactone on the Risk of New-Onset Diabetes in a Cohort of Patients with Heart Failure

Use of Statins and the Risk of Incident Diabetes: A Retrospective Cohort Study.

Even though several landmark statin trials have demonstrated the beneficial effects of statin therapy in both primary and secondary prevention of cardiovascular disease, several studies have suggested that statins are associated with a moderate increase in risk of new-onset diabetes. These observations prompted the US FDA to revise statin labels to include a warning of an increased risk of incident diabetes mellitus as a result of increases in glycosylated hemoglobin (HbA1c) and fasting plasma glucose. However, few studies have used US-based data to investigate this statin-associated increased risk of diabetes. The primary objective of our study was to examine whether the use of statins increases the risk of incident diabetes mellitus using data from the Thomson Reuters MarketScan (®) Commercial Claims and Encounters Database. This study was a retrospective cohort analysis utilizing data for the period 2003-2004. The study population included new statin users aged 20-63years at index who did not have a history of diabetes. The proportion (3.4%) of statin users (N=53,212) who had incident diabetes was higher than the proportion (1.2%) of non-statin users (N=53,212) who had incident diabetes. Compared with no statin use and controlling for demographic and clinical covariates, statin use was significantly associated with increased risk of incident diabetes (hazard ratio 2.01; 99% confidence interval 1.74-2.33; p<0.0001). In addition, risk of diabetes was highest among users of lovastatin, atorvastatin, simvastatin, and fluvastatin. Diabetes risk was lowest among pravastatin and rosuvastatin users. Because the potential for diabetogenicity differs among different statin types, healthcare professionals should individualize statin therapy by identifying patients who would benefit more from less diabetogenic statin types.

Research progress on statins use and the risk of new onset diabetes

Research progress on statins use and the risk of new onset diabetes

PDB15 - USE OF STATINS AND THE RISK OF INCIDENT DIABETES: A RETROSPECTIVE COHORT STUDY

Even though several landmark statin trials have demonstrated the beneficial effects of statin therapy in both primary and secondary prevention of cardiovascular disease, several studies have suggested that statins are associated with a moderate increase in risk of new-onset diabetes. These observations prompted the US FDA to revise statin labels to include a warning of an increased risk of incident diabetes mellitus as a result of increases in glycosylated hemoglobin (HbA1c) and fasting plasma glucose. However, few studies have used US-based data to investigate this statin-associated increased risk of diabetes. The primary objective of our study was to examine whether the use of statins increases the risk of incident diabetes mellitus using data from the Thomson Reuters MarketScan ® Commercial Claims and Encounters Database. This study was a retrospective cohort analysis utilizing data for the period 2003–2004. The study population included new statin users aged 20–63 years at index who did not have a history of diabetes. The proportion (3.4 %) of statin users (N = 53,212) who had incident diabetes was higher than the proportion (1.2 %) of non-statin users (N = 53,212) who had incident diabetes. Compared with no statin use and controlling for demographic and clinical covariates, statin use was significantly associated with increased risk of incident diabetes (hazard ratio 2.01; 99 % confidence interval 1.74–2.33; p < 0.0001). In addition, risk of diabetes was highest among users of lovastatin, atorvastatin, simvastatin, and fluvastatin. Diabetes risk was lowest among pravastatin and rosuvastatin users. Because the potential for diabetogenicity differs among different statin types, healthcare professionals should individualize statin therapy by identifying patients who would benefit more from less diabetogenic statin types.

Doppler ultrasound in kidney diseases: a key parameter in clinical long-term follow-up.

Doppler ultrasound has been extensively used in detecting reno-vascular diseases, showing to be a non-invasive, safe, low cost and repeatable tool. The Renal Resistive Index (RRI) [(peak systolic velocity-end diastolic velocity)/peak systolic velocity] is a semi-quantitative index derived by Doppler evaluation of renal vascular bed. Normally RRI is in the range of 0.47-0.70, it increases with aging and, usually, it shows a difference between the two kidneys less than 5-8%. RRI is an important prognostic marker in chronic kidney diseases (CKD), both in diabetic and non-diabetic kidney diseases, because, in longitudinal prospective studies, it significantly correlated with hemodynamic (ABPM, SBP, DBP, pulse pressure) and histopathological parameters (glomerular sclerosis, arteriolosclerosis, interstitial fibrosis/tubular atrophy, interstitial infiltration). In acute kidney injury (AKI) RI is a valid tool in differentiating between pre-renal and renal failure and in predicting renal response to vaso-active agents. In addition a RRI >0.74 can predict the onset of AKI in septic patients. Renal Resistive Index is a useful marker in allograft diseases because it has been widely showed a correlation with histological lesions during worsening of renal function, both in acute rejection and in chronic allograft nephropathy. Recent studies suggest its role in the risk of new onset diabetes after transplantation and it could be one of the parameters to evaluate to shift or withdrawal immunological and/or hypertensive therapy.