Frailty is associated with a higher risk of developing delirium and cognitive impairment among patients with diabetic kidney disease: A longitudinal population‐based cohort study

2021 ◽  
Author(s):  
Szu‐Ying Lee ◽  
Jui Wang ◽  
Chia‐Ter Chao ◽  
Kuo‐Liong Chien ◽  
Jenq‐Wen Huang
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Population Based ◽  
Diabetic Kidney

Baseline High-Sensitivity C-Reactive Protein Predicts Macrovascular and Microvascular Complications of Type 2 Diabetes: A Population-Based Study

2018 ◽  
Vol 72 (4) ◽  
pp. 287-295 ◽  
Author(s):  
Zahra Aryan ◽  
Alireza Ghajar ◽  
Sara Faghihi-Kashani ◽  
Mohsen Afarideh ◽  
Manouchehr Nakhjavani ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Microvascular Complications ◽  
High Sensitivity ◽  
Population Based ◽  
End Points ◽  
Diabetic Kidney ◽  
Reactive Protein ◽  
Hs Crp ◽  
Traditional Risk Factors

Background/Aims: This prospective study is aimed at examining the predictive value of high-sensitivity C-reactive protein (hs-CRP) for coronary heart disease (CHD) events and microvascular complications of type 2 diabetes mellitus (T2DM). Methods: A population-based study (NCT02958579) was conducted on 1,301 participants with T2DM (mean follow-up of 7.5 years). Risk assessment for vascular events was done at baseline, and serum hs-CRP was measured. End points of this study include CHD events, diabetic retinopathy, neuropathy, and diabetic kidney disease. Individuals with unavailable data or hs-CRP >20 mg/L were excluded. The discrimination and reclassification improvement of study end points were tested after addition of hs-CRP to traditional risk factors. Results: Median serum hs-CRP was 2.00 ranging from 0.1 to 17 mg/L. Hazards ratio of each SD increment in baseline hs-CRP was 1.028 (1.024–1.032) for CHD, 1.025 (1.021–1.029) for diabetic neuropathy, 1.037 (1.030–1.043) for diabetic retinopathy, and 1.035 (1.027–1.043) for diabetic kidney disease. The addition of hs-CRP to traditional risk factors of vascular complications of T2DM improved discrimination of all end points (p < 0.001). Net reclassification improvement ranged from 8% for diabetic neuropathy to 31% for diabetic kidney disease (p < 0.05). Conclusion: Baseline hs-CRP predicts both of CHD events and microvascular complications of patients with T2D.

scholarly journals Nonproteinuric Versus Proteinuric Phenotypes in Diabetic Kidney Disease: A Propensity Score–Matched Analysis of a Nationwide, Biopsy-Based Cohort Study

Diabetes Care ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. 891-902 ◽  
Author(s):  
Masayuki Yamanouchi ◽  
Kengo Furuichi ◽  
Junichi Hoshino ◽  
Tadashi Toyama ◽  
Akinori Hara ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Propensity Score ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney

scholarly journals Burden of Undiagnosed Type 2 Diabetes in Diabetic Kidney Disease: A Japanese Retrospective Cohort Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2028
Author(s):  
Hayato Tanabe ◽  
Haruka Saito ◽  
Noritaka Machii ◽  
Akihiro Kudo ◽  
Kenichi Tanaka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Kidney Disease ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Diabetic Kidney Disease ◽  
Undiagnosed Diabetes ◽  
Diabetic Kidney

The risk of developing diabetic kidney disease (DKD) in patients with undiagnosed diabetes mellitus (UD) has never been evaluated. We studied the burden of UD on the risk of developing DKD in the Japanese population in a single-center retrospective cohort study. The patients with type 2 diabetes mellitus, but without DKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or proteinuria), were recruited from January 2018 to January 2019; medical records were scrutinized retrospectively from January 2003 until May 2019. The individuals, with diabetes that could not be denied based on past and current records, comprised the undiagnosed diabetes (UD) group whereas those with confirmed diagnosis comprised the diagnosed diabetes (DD) group. The group differences were tested using a Kaplan–Meier curve and Cox proportional hazards model. Among the 408 participants, 164 (40.2%) and 244 (59.8%) comprised the DD and UD groups, respectively. The baseline parameters, including age, male gender, and BMI were comparable between the groups, but the plasma glucose, HbA1c levels, and diabetic retinopathy prevalence were higher in the UD group. The risk of developing DKD (log rank test, p < 0.001), an eGFR of < 60 mL/min/1.73 m2 (p = 0.001) and proteinuria (p = 0.007) were also higher in the UD group. The unadjusted and adjusted hazard ratios for DKD were 1.760 ((95% CI: 1.323–2.341), p < 0.001) and 1.566 ((95% CI: 1.159–2.115), p = 0.003), respectively, for the UD group. In conclusion, this is the first report showing that UD is a strong risk factor for DKD. The notion that a longer duration of untreated diabetes mellitus is involved strongly in the risk of developing DKD warrants the need for the identification and monitoring of UD patients.

scholarly journals Epidemiology and outcomes of hypoglycemia in patients with advanced diabetic kidney disease on dialysis: A national cohort study

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0174601 ◽  
Author(s):  
Yeh-Wen Chu ◽  
Hsuan-Ming Lin ◽  
Jhi-Joung Wang ◽  
Shih-Feng Weng ◽  
Chih-Ching Lin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Diabetic Kidney ◽  
National Cohort

scholarly journals Obstructive sleep apnoea and the risk for coronary heart disease and type 2 diabetes: a longitudinal population-based study in Finland

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022752 ◽  
Author(s):  
Satu Strausz ◽  
Aki S. Havulinna ◽  
Tiinamaija Tuomi ◽  
Adel Bachour ◽  
Leif Groop ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Population Based ◽  
Sleep Apnoea ◽  
Population Based Study ◽  
Diabetic Kidney ◽  
Obstructive Sleep

ObjectiveTo evaluate if obstructive sleep apnoea (OSA) modifies the risk of coronary heart disease, type 2 diabetes (T2D) and diabetic complications in a gender-specific fashion.Design and settingA longitudinal population-based study with up to 25-year follow-up data on 36 963 individuals (>500 000 person years) from three population-based cohorts: the FINRISK study, the Health 2000 Cohort Study and the Botnia Study.Main outcome measuresIncident coronary heart disease, diabetic kidney disease, T2D and all-cause mortality from the Finnish National Hospital Discharge Register and the Finnish National Causes-of-Death Register.ResultsAfter adjustments for age, sex, region, high-density lipoprotein (HDL) and total cholesterol, current cigarette smoking, body mass index, hypertension, T2D baseline and family history of stroke or myocardial infarction, OSA increased the risk for coronary heart disease (HR=1.36, p=0.0014, 95% CI 1.12 to 1.64), particularly in women (HR=2.01, 95% CI 1.31 to 3.07, p=0.0012). T2D clustered with OSA independently of obesity (HR=1.48, 95% CI 1.26 to 1.73, p=9.11×10−7). The risk of diabetic kidney disease increased 1.75-fold in patients with OSA (95% CI 1.13 to 2.71, p=0.013). OSA increased the risk for coronary heart disease similarly among patients with T2D and in general population (HR=1.36). All-cause mortality was increased by OSA in diabetic individuals (HR=1.35, 95% CI 1.06 to 1.71, p=0.016).ConclusionOSA is an independent risk factor for coronary heart disease, T2D and diabetic kidney disease. This effect is more pronounced even in women, who until now have received less attention in diagnosis and treatment of OSA than men.

1511-P: Diabetic Kidney Disease and Visit-to-Visit Variability of HbA1c, Blood Pressure, and Body Mass Index: A Nationwide Population-Based Study (ABB-DKD Study, JDDM)

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1511-P
Author(s):  
DAISUKE MATSUTANI ◽  
SOICHIRO MINATO ◽  
YUKI TSUJIMOTO ◽  
HIROSHI MAEGAWA ◽  
MASAYA SAKAMOTO
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Kidney Disease ◽  
Body Mass ◽  
Diabetic Kidney Disease ◽  
Population Based ◽  
Population Based Study ◽  
Diabetic Kidney

scholarly journals Muscle relaxant use and the associated risk of incident frailty in patients with diabetic kidney disease: a longitudinal cohort study

2021 ◽  
Vol 12 ◽  
pp. 204209862110146
Author(s):  
Szu-Ying Lee ◽  
Jui Wang ◽  
Hung-Bin Tsai ◽  
Chia-Ter Chao ◽  
Kuo-Liong Chien ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Muscle Relaxant ◽  
Diabetic Kidney Disease ◽  
Population Based ◽  
Muscle Relaxants ◽  
Proportional Hazard ◽  
Longitudinal Cohort ◽  
Diabetic Kidney ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression

Background: Patients with diabetic kidney disease (DKD) are at an increased risk of frailty. The exposure to muscle relaxants frequently leads to adverse effects despite their modest therapeutic efficacy, but whether muscle relaxants predispose users to frailty remains unclear. Methods: Patients with DKD from a population-based cohort, the Longitudinal Cohort of Diabetes Patients, were identified between 2004 and 2011 ( N = 840,000). Muscle relaxant users were propensity score-matched to never-users in a 1:1 ratio based on demographic features, comorbidities, outcome-relevant medications, and prior major interventions. Incident frailty, the study endpoint, was measured according to a modified FRAIL scale. We used Kaplan–Meier analyses and Cox proportional hazard regression to analyze the association between cumulative muscle relaxant use (⩾ 28 days) and the risk of incident frailty. Results: Totally, 11,637 users and matched never-users were enrolled, without significant differences regarding baseline clinical features. Cox proportional hazard regression showed that patients with DKD and received muscle relaxants had a significantly higher risk of incident frailty than never-users [hazard ratio (HR) 1.26, 95% confidence interval (CI) 1.04–1.53]. This increase in frailty risk paralleled that in cumulative muscle relaxant dosages (quartile 1 versus 2 versus 3 versus 4, HR 0.91 versus 1.22 versus 1.38 versus 1.45, p = 0.0013 for trend) and in exposure durations (quartile 1 versus 2 versus 3 versus 4, HR 1.12 versus 1.33 versus 1.23 versus 1.34, p = 0.0145 for trend) of muscle relaxants. Conclusion: We found that cumulative muscle relaxant exposure might increase frailty risk. It is prudent to limit muscle relaxant prescription in patients with DKD. Plain language summary Does cumulative muscle relaxant exposure increase the risk of incident frailty among patients with diabetic kidney disease? Background: Frailty denotes a degenerative feature that adversely influences one’s survival and daily function. Patients with diabetes and chronic kidney disease are at a higher risk of developing frailty, but whether concurrent medications, especially muscle relaxants, aggravate this risk remains undefined. Methods: In this population-based study including 11,637 muscle relaxant users and matched never-users with diabetic kidney disease, we used a renowned frailty-assessing tool, FRAIL scale, to assess frailty severity and examined the incidence of frailty brought by muscle relaxant exposure. Results: We found that users exhibited a 26% higher risk of developing incident frailty compared with never-users, and the probability increased further if users were prescribed higher doses or longer durations of muscle relaxants. Conclusion: We concluded that in those with diabetic kidney disease, cumulative muscle relaxant use was associated with a higher risk of incident frailty, suggesting that moderation of muscle relaxant use in this population can be of potential importance.

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