Estimated glomerular filtration rate progression in UK primary care patients with type 2 diabetes and diabetic kidney disease: a retrospective cohort study

2015 ◽  
Vol 69 (8) ◽  
pp. 871-882 ◽  
Author(s):  
J. Cid Ruzafa ◽  
R. Paczkowski ◽  
K. S. Boye ◽  
G. L. Di Tanna ◽  
M. J. Sheetz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Glomerular Filtration Rate ◽  
Retrospective Cohort ◽  
Filtration Rate ◽  
Diabetic Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Primary Care Patients

scholarly journals A synergistic effect of variability in estimated glomerular filtration rate with chronic kidney disease on all-cause mortality prediction in patients with type 2 diabetes: a retrospective cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu-Shan Chang ◽  
Yu-Hsuan Li ◽  
I-Te Lee
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Glomerular Filtration Rate ◽  
Retrospective Cohort ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Mortality Prediction ◽  
Type 2 Dm ◽  
All Cause Mortality

Abstract Background The combination of diabetes mellitus (DM) and chronic kidney disease (CKD) is associated with a high risk of mortality. Annual assessment of the estimated glomerular filtration rate (eGFR) is recommended for patients with DM. We investigated the effect of variability in annual eGFR values on all-cause mortality in patients with type 2 DM. Methods In this retrospective cohort study, we enrolled patients with eGFR data between 01 Aug 2017 and 31 July 2018. We defined the index eGFR as the first available eGFR value within the enrollment year and collected additional annual eGFR data from the previous three years. A total of 3592 patients with type 2 DM were enrolled, including 959 patients with CKD (index eGFR < 60 mL/min/1.73 m2) and 2633 patients without CKD. We assessed eGFR variability by using the standard deviation (SD) of the three annual eGFR and index eGFR values. We divided patients into subgroups according to the median SD of their annual eGFR (7.62 mL/min/1.73 m2). The primary endpoint was all-cause mortality after the index eGFR was assessed. Results During a median follow-up of 19 months (interquartile range: 18‒20 months), 127 (3.5%) deaths occurred among all 3592 enrolled patients. The highest mortality risk was observed in the high SD with CKD group, with a hazard ratio (HR) of 2.382 [95% confidence interval (CI) 1.346‒4.215] in comparison to the low SD without CKD group after adjusting for the associated factors. In patients without CKD, a high SD was an independent risk factor for mortality (HR = 2.105, 95% CI 1.256‒3.528). According to the C-index, the mortality prediction ability was better for the index eGFR + SD model than for the index eGFR alone model (0.671 vs. 0.629, P < 0.001). Conclusion There was a synergistic effect of eGFR variability with single-measured eGFR for the prediction of mortality in patients with type 2 DM. The SD of the annual eGFR values was also an independent predictor of mortality in patients with an eGFR > 60 mL/min/1.73 m2.

scholarly journals Serum Uric Acid Levels and Risk of Rapid Decline of Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes: Findings from a 5-Year Prospective Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1341
Author(s):  
Hoa Tuyet Le ◽  
Tung Thanh Le ◽  
Nguyet Minh Thi Tran ◽  
Thuy Thanh Thi Nguyen ◽  
Ni Chanh Su Minh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Uric Acid ◽  
Cohort Study ◽  
Glomerular Filtration Rate ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Rapid Decline ◽  
Rapid Progression

This study investigated the association between serum uric acid (SUA) levels with rapid decline of the estimated glomerular filtration rate (eGFR) in type 2 diabetes (T2 DM) patients. A prospective cohort study was conducted in a community-based hospital in Vietnam. We followed 405 T2DM patients with normal kidney function for five years. Rapid progression of kidney function was defined as an average annual decrease of eGFR of at least 4 mL/min/1.73 m2 and was found in 16.0% of patients. Patients in the SUA high tertile ( ≥6 mg/dL) had higher BMI (p = 0.004), lower HbA1c (p = 0.001), lower eGFR (p < 0.001) and higher rate of hypertension than low and middle tertile. After adjusting for age and sex, rapid progression of renal function was significantly associated with SUA level (OR = 1.22, 95% CI 1.02–1.45, p = 0.026). This association was marginally significant when more covariates were included in the model (OR = 1.20, 95% CI 0.99–1.46, p = 0.065). However, the association between tertiles of SUA and rapid decline of eGFR was not statistically significant. This study demonstrates neither a strong significant association between SUA and rapid decline of eGFR nor evidence to refuse the role of SUA levels in the increased risk of renal function decline in in T2DM patients.

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