scholarly journals Prevalence of Chronic Kidney Disease in Patients with Diabetes in Extremadura (Spain) during the Years 2012, 2013 and 2014: An Observational Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2886
Author(s):  
Leandro Fernández-Fernández ◽  
Alfonso Barquilla-García ◽  
Javier Sánchez-Vega ◽  
José Carlos Risco-Solanilla ◽  
Félix Suárez-González ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Observational Study ◽  
Risk Category ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Time Period ◽  
Patients With Diabetes ◽  
Diabetic Population ◽  
Very High

Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD). We analyzed the prevalence of CKD in the population with diabetes in Extremadura (Spain). retrospective observational study was carried in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 38,253 patients, ≥18 years old were included. Estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration equation. CKD was defined as follow: an eGFR <60 mL/min/1.73 m2 in a time period ≥ of three months or the presence of renal damage, with or without reduced eGFR, if the urine albumin-creatinine ratio (UACR) was ≥30 mg/g, also in a time period ≥ of three months. The prevalence rate of CKD was 25.3% (27.6% in women; 23.0% in men) and increases with age (34.0% in ≥65 years-olds). 24.9% of patients with CKD were in the very-high risk category for cardiovascular events (6.3% of the diabetic population). If CKD were diagnosed without requiring sustained eGFR <60 mL/min/1.73 m2 and/or sustained UACR ≥30 mg/g (as it is frequently found in the literature) this would overestimate the prevalence of CKD by 23%.

scholarly journals Risk for recurrent cardiovascular disease events among patients with diabetes and chronic kidney disease

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Demetria Hubbard ◽  
Lisandro D. Colantonio ◽  
Robert S. Rosenson ◽  
Todd M. Brown ◽  
Elizabeth A. Jackson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Health Insurance ◽  
High Risk ◽  
Kidney Disease ◽  
Peripheral Artery ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Very High

Abstract Background Adults who have experienced multiple cardiovascular disease (CVD) events have a very high risk for additional events. Diabetes and chronic kidney disease (CKD) are each associated with an increased risk for recurrent CVD events following a myocardial infarction (MI). Methods We compared the risk for recurrent CVD events among US adults with health insurance who were hospitalized for an MI between 2014 and 2017 and had (1) CVD prior to their MI but were free from diabetes or CKD (prior CVD), and those without CVD prior to their MI who had (2) diabetes only, (3) CKD only and (4) both diabetes and CKD. We followed patients from hospital discharge through December 31, 2018 for recurrent CVD events including coronary, stroke, and peripheral artery events. Results Among 162,730 patients, 55.2% had prior CVD, and 28.3%, 8.3%, and 8.2% had diabetes only, CKD only, and both diabetes and CKD, respectively. The rate for recurrent CVD events per 1000 person-years was 135 among patients with prior CVD and 110, 124 and 171 among those with diabetes only, CKD only and both diabetes and CKD, respectively. Compared to patients with prior CVD, the multivariable-adjusted hazard ratio for recurrent CVD events was 0.92 (95%CI 0.90–0.95), 0.89 (95%CI: 0.85–0.93), and 1.18 (95%CI: 1.14–1.22) among those with diabetes only, CKD only, and both diabetes and CKD, respectively. Conclusion Following MI, adults with both diabetes and CKD had a higher risk for recurrent CVD events compared to those with prior CVD without diabetes or CKD.

Abstract 13169: US Prevalence Estimates of Individuals With Diabetes and Chronic Kidney Disease Indicated for SGLT-2 Inhibitor Initiation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Rahul Aggarwal ◽  
Kimberly Lu ◽  
Nicholas Chiu ◽  
George Bakris ◽  
Deepak L Bhatt
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
The United States ◽  
Stage Iii ◽  
First Line ◽  
First Line Therapy ◽  
Urine Albumin ◽  
The Us ◽  
Patients With Diabetes

Introduction: Since the CREDENCE trial results, the American Diabetes Association (ADA) recommends SGLT-2 inhibitors as first line therapy for patients with stage III Chronic Kidney Disease (CKD) or proteinuric CKD, regardless of baseline A1C. We project the number of US individuals with diabetes and renal disease that meets inclusion into the CREDENCE trial and that are recommended for SGLT-2 inhibitors based on the guidelines. Methods: Our initial cohort consisted of 48,710 individuals from the 2007-2016 National Health and Nutrition Examination Survey with survey weights designed to estimate the US population. CREDENCE eligible patients were patients with diabetes who had an eGFR of 30-90 and urine albumin-to-creatinine ratio (UACR) of >300 mg/g. Guideline eligible patients were stage III CKD individuals and those with a UACR > 30 mg/g. Results: In the US population, 21,411,059 (+/-708,233) individuals are >=18 years and have diabetes. Of these individuals, 578,514 (+/-72,385) are CREDENCE eligible. Based on the ADA recommendations, 7,504,508 (+/- 342,139) adults with CKD and diabetes are recommended for an SGLT-2 inhibitor, representing 35.0% of individuals with diabetes. The mean age of guideline eligible individuals is 64.4 years, with 3,886,904 males (51.8%) and 3,617,604 females (48.2%). Conclusions: In the United States, a large number of individuals--approximately 35% of adults with diabetes--have renal disease characteristics that give them a first-line indication for SGLT-2 inhibitor initiation.

scholarly journals The role of urine albumin creatinine ratio and serum β2 microglobulin as biomarkers of chronic kidney disease

2019 ◽  
Vol 38 (3) ◽  
pp. 172
Author(s):  
Augustine Onovuakpo Eguvbe ◽  
Marcellinus Uchechukwu Nwagu ◽  
Eshiotseme Sylvester Idogun ◽  
Adeyinka Abdulrasaq Akande
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Receiver Operating Curve ◽  
Strong Positive Correlation ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Β2 Microglobulin ◽  
Urine Albumin ◽  
Urine Albumin Creatinine Ratio

<p><strong>BACKGROUND</strong></p><p>Chronic kidney disease (CKD) is an increasing burden on individuals and on the healthcare system. The need to identify more sensitive and specific markers of CKD cannot be overemphasized to facilitate detection and appropriate intervention. β2 microglobulin is one of such markers of CKD. The aim of this study was to investigate the sensitivities and specificities of serum β2 microglobulin and major biochemical markers of CKD, namely creatinine and urine albumin.</p><p><strong> </strong></p><p><strong>METHODS</strong></p><p>This was a hospital-based cross-sectional study involving 124 subjects with CKD and 124 healthy controls. Participants were categorized in two groups : group 1 the CKD based on persistent reduction in GFR &lt;60 mL/min/1.73 m2 and group 2 healthy subjects as controls. Blood (serum) samples of participants were analyzed for serum creatinine and serum β2 microglobulin while their urine samples were analyzed for creatinine and albumin. Urine albumin creatinine ratio (UACR) was calculated from the results of the analyses.</p><p><strong> </strong></p><p><strong>RESULTS</strong></p><p>There was a very strong positive correlation of serum β2 microglobulin with serum creatinine (r=0.750; p=0.000) and UACR (r=0.775; p=0.000), respectively. Also, there was a very strong negative correlation between serum β2 microglobulin and eGFR (r=-0.866; p=0.000). UACR had the highest sensitivity and specificity as shown by receiver operating curve characteristics (ROC) analysis.</p><p><strong> </strong></p><p><strong>CONCLUSION</strong></p><p>In CKD, UACR and serum β2 microglobulin had the best diagnostic value. Periodic renal assessment of renal patients is mandatory as they may be affected by hidden renal dysfunction.</p>

scholarly journals Chronic Kidney Disease Testing Among At-Risk Adults in the U.S. Remains Low: Real-World Evidence From a National Laboratory Database

2021 ◽  
Author(s):  
David Alfego ◽  
Jennifer Ennis ◽  
Barbara Gillespie ◽  
Mary Jane Lewis ◽  
Elizabeth Montgomery ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Kidney Disease ◽  
Clinical Laboratory ◽  
Clinical Care ◽  
National Laboratory ◽  
The United States ◽  
Urine Albumin ◽  
Diagnosis Codes ◽  
Patients With Diabetes

<p><i>Objective:</i> An estimated 37 million Americans have chronic kidney disease (CKD). Nearly 90% do not know about their condition because of low awareness about the importance of CKD testing and diagnosis among practitioners and people at-risk for CKD. This study utilizes data from a national clinical laboratory to identify guideline-recommended CKD testing rates across the United States.</p> <p><i>Research Design and Methods:</i> Patients with Laboratory Corporation of America® Holdings (Labcorp®) testing between 2013 and 2019 were defined as at-risk for CKD if they had any testing ordered with diagnosis codes for diabetes and/or hypertension. Guideline-concordant CKD assessment was defined by estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR) testing within the study year.</p> <p><i>Results:</i> We identified 28,295,982 at-risk patients (mean age 60.6 ± 14.8 y, 53.6% women): 16.2% had diabetes, 63.8% had hypertension and 20.1% had both comorbidities. Of these, 80.3% did not receive guideline-concordant assessment during the study period. Furthermore, only 21.0% had uACR testing versus 89.6% with eGFR. CKD assessment occurred at least once in 28.7% of patients with diabetes, 10.5% of hypertensive, and 41.4% of those with both. In a state-by-state comparison, annual testing rates ranged from 5% - 30%. The nationwide rate increased modestly each year between 2013 and 2018 (10.7% to 15.2%).</p> <p><i>Conclusions:</i> Despite guideline recommendations, testing for CKD with uACR and eGFR in U.S. adults with diabetes and hypertension is low in routine clinical care. These data highlight the need for strategies to improve routine CKD assessment nationwide.</p>

Abstract P602: Patiromer Decreased Aldosterone, Urine Albumin/Creatinine Ratio, and Blood Pressure in Patients with Chronic Kidney Disease and Hyperkalemia on RAAS Inhibitors: Results from OPAL-HK

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Matthew Weir ◽  
George Bakris ◽  
Coleman Gross ◽  
Martha Mayo ◽  
Dahlia Garza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Plasma Renin ◽  
Creatinine Ratio ◽  
Phase 3 ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Raas Inhibitors ◽  
Withdrawal Phase

Introduction: Elevated aldosterone (ALD) is associated with chronic kidney disease (CKD) and cardiovascular (CV) complications. Patiromer, a nonabsorbed potassium (K + )-binding polymer, decreases serum K + (sK + ) and may allow increased use of RAAS inhibitors (RAASi) in patients (pts) with CKD and hyperkalemia (HK). This analysis examined the effect of patiromer on ALD, urinary albumin/creatinine ratio (ACR), and blood pressure (BP) in pts with CKD on RAASi. Methods: OPAL-HK was a 2-part, phase 3 study in 243 CKD pts with sK + 5.1–<6.5 mEq/L on RAASi. Pts received patiromer for 4 wks (Part A); pts with moderate-severe HK at baseline (sK + ≥5.5 mEq/L) and sK + 3.8–<5.1 at Part A wk 4 continued on patiromer (n=55) or switched to placebo (n=52) in the 8-wk withdrawal phase (Part B). RAASi were stable prior to and during Part A. Changes in ALD, ACR, and systolic BP/diastolic BP (SBP/DBP) were analyzed. Results: After 4 wks of patiromer sK + , serum ALD and urine ALD/creatinine decreased, while plasma renin activity (PRA) was unchanged; SBP, DBP, and ACR also declined (Table). Mean±SE changes (ng/dL) in serum ALD from Part A wk 4 to Part B wk 4 and to Part B wk 8 were 4.6±1.6 (p<0.01) and 5.7±1.8 (p<0.01) in the placebo and 0.9±1.0 (p=NS) and 0.2±0.8 (p=NS) in the patiromer groups, respectively. Compared with Part A wk 4, SBP (mm Hg) was further reduced at Part B wk 4 (3.1±2.1, p=NS) and Part B wk 8 (5.4±1.9, p<0.01) with maintained improvement in ACR in patiromer pts. Conclusions: Patiromer reduced both sK + and ALD (independent of PRA) in CKD pts with HK on RAASi. ALD reductions correlated with lower BP and ACR. Reduction in sK + may have lowered ALD possibly improving BP and ACR.

scholarly journals Chronic Kidney Disease Testing Among At-Risk Adults in the U.S. Remains Low: Real-World Evidence From a National Laboratory Database

2021 ◽  
Author(s):  
David Alfego ◽  
Jennifer Ennis ◽  
Barbara Gillespie ◽  
Mary Jane Lewis ◽  
Elizabeth Montgomery ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
At Risk ◽  
Kidney Disease ◽  
Clinical Laboratory ◽  
Clinical Care ◽  
National Laboratory ◽  
The United States ◽  
Urine Albumin ◽  
Diagnosis Codes ◽  
Patients With Diabetes

<p><i>Objective:</i> An estimated 37 million Americans have chronic kidney disease (CKD). Nearly 90% do not know about their condition because of low awareness about the importance of CKD testing and diagnosis among practitioners and people at-risk for CKD. This study utilizes data from a national clinical laboratory to identify guideline-recommended CKD testing rates across the United States.</p> <p><i>Research Design and Methods:</i> Patients with Laboratory Corporation of America® Holdings (Labcorp®) testing between 2013 and 2019 were defined as at-risk for CKD if they had any testing ordered with diagnosis codes for diabetes and/or hypertension. Guideline-concordant CKD assessment was defined by estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR) testing within the study year.</p> <p><i>Results:</i> We identified 28,295,982 at-risk patients (mean age 60.6 ± 14.8 y, 53.6% women): 16.2% had diabetes, 63.8% had hypertension and 20.1% had both comorbidities. Of these, 80.3% did not receive guideline-concordant assessment during the study period. Furthermore, only 21.0% had uACR testing versus 89.6% with eGFR. CKD assessment occurred at least once in 28.7% of patients with diabetes, 10.5% of hypertensive, and 41.4% of those with both. In a state-by-state comparison, annual testing rates ranged from 5% - 30%. The nationwide rate increased modestly each year between 2013 and 2018 (10.7% to 15.2%).</p> <p><i>Conclusions:</i> Despite guideline recommendations, testing for CKD with uACR and eGFR in U.S. adults with diabetes and hypertension is low in routine clinical care. These data highlight the need for strategies to improve routine CKD assessment nationwide.</p>

scholarly journals Prevalence of Early Chronic Kidney Disease and Main Associated Factors in Spanish Population: Populational Study

2019 ◽  
Vol 8 (9) ◽  
pp. 1384 ◽  
Author(s):  
Carmen Expósito ◽  
Guillem Pera ◽  
Lluís Rodríguez ◽  
Ingrid Arteaga ◽  
Alba Martínez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Multivariate Logistic Regression Model ◽  
Creatinine Ratio ◽  
Multivariate Logistic Regression ◽  
Albumin Creatinine Ratio ◽  
Factors Associated ◽  
Urine Albumin ◽  
Primary Healthcare Centers

The aim of this study was to determine the prevalence of early chronic kidney disease (EKD) (stages 1 and 2) and the factors associated. This was a populational study including individuals from 18–75 years randomly selected from 18 Primary Healthcare centers in the area of Barcelonès Nord and Maresme (Catalunya, Spain). Variables: anamnesis, physical examination, blood pressure, and analysis. EKD was defined with by a glomerular filtration rate (GFR) ≥60 mL/min/1.73 m2 and albumin/creatinine ratio (ACR) ≥17 mg/g in men and ≥25 mg/g in women confirmed with two determinations. 2871 individuals: 43% men, mean age 55 years (19–75), 32.2% obese, 50.5% abdominal obesity, 21.1% hypertensive, and 10.6% diabetic. Prevalence of EKD: With one determination 157 individuals (5.5%), 110 men (9%) and 47 women (2.8%); with two determinations 109 individuals (3.8%), 85 men (7%), and 24 women (1.5%). Factors independently associated with the multivariate logistic regression model: Man (OR 3.35), blood pressure ≥ 135/85 mmHg (OR 2.29), BMI ≥ 30 kg/m2 (OR 2.48), glycemia ≥ 100 mg/dL (OR 1.73), smoker (OR 1.67) and age (OR 1.04). The prevalence varies if the diagnosis is established based on one or two analytical determinations, overestimated if only one determination is made and depends on the value chosen to define urine albumin excretion.

scholarly journals Glucose-lowering therapies in patients with diabetes mellitus and chronic kidney disease

2013 ◽  
Vol 16 (3) ◽  
pp. 97-102 ◽  
Author(s):  
Minara Shamkhalovna Shamkhalova ◽  
Ivona Renata Yarek-Martynova ◽  
Natalya Petrovna Trubitcyna ◽  
Marina Vladimirovna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glucose Lowering ◽  
Patients With Diabetes ◽  
Stimulation Of Erythropoiesis ◽  
Metabolic Degradation ◽  
Diabetic Population

Expansion of diabetic population (predominantly due to type 2 diabetes mellitus) with chronic kidney disease (CKD) comorbidityconstitutes one of the major challenges in modern medicine.Throughout the course of diabetes nephropathy development, from its debut to the terminal stage, survival rate and quality of life arelower than those of other categories of patients. This indicates crucial role of hyperglycemia in accelerated metabolic degradation typicalof CKD.Renal disease severely narrows the spectrum of available glucose-lowering agents. Concurrent treatment for hypertension and dyslipidemia,as well as anti-platelet therapy and stimulation of erythropoiesis becomes a complex issue. A creative and patient-orientedapproach with clear metabolic and cardiovascular goals should be instrumental in its solution.

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