Rate of Kidney Function Decline and Factors Predicting Progression of Kidney Disease in Type 2 Diabetes Mellitus Patients with Reduced Kidney Function: A Nationwide Retrospective Cohort Study.

Kaewput, Wisit and Thongprayoon, Charat and Chewcharat, Api and Rangsin, Ram and Satirapoj, Bancha and Kaewput, Chalermrat and Suwannahitatorn, Picha and Bathini, Tarun and Mao, Michael A and Cato, Liam D and Harrison, Andrew M and Vaitla, Pradeep and Cheungpasitporn, Wisit (2020) Rate of Kidney Function Decline and Factors Predicting Progression of Kidney Disease in Type 2 Diabetes Mellitus Patients with Reduced Kidney Function: A Nationwide Retrospective Cohort Study. Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy. ISSN 1744-9987. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/17...

Abstract

OBJECTIVES

Currently, the data on independent risk factors for the progression of kidney disease in type 2 diabetes mellitus (T2DM) patients with CKD were limited. This study aimed to investigate CKD progression in T2DM patients who have reduced kidney function with baseline eGFRs between 15 and 59 mL/min/1.73 m .

METHODS

This study was composed of a nationwide retrospective cohort of adult T2DM patients from 831 public hospitals in Thailand during the year 2015. T2DM patients with CKD stage 3-4 were followed up until development of CKD stage 5, requirement of chronic dialysis, loss to follow-up, death, or May 31st, 2018, whichever came first. Cox proportional hazard regression was utilized to analysis.

RESULTS

A total of 8464 participants were included. 30.4% were male. The mean age was 69 ± 10 years. The mean eGFR was 45 ± 11 mL/min/1.73 m . The incidence of CKD stage 5 or need for chronic dialysis was 16.4 per 1000 person-years. The annual rate of eGFR decline during a mean follow-up of 29 months was -2.3 mL/min/1.73 m . 14.4% had a rapid decline in eGFR. The risk factors associated with progression to CKD stage 5 or need for chronic dialysis were diabetes duration, systolic blood pressure, serum uric acid, albuminuria, and baseline eGFR. Conversely, older age and the use of renin-angiotensin aldosterone system blockades were associated with decreased risks for rapid CKD progression and incidence CKD stage 5 or dialysis.

CONCLUSION

This study identifies multiple predictive risk factors that support a multifaceted approach to prevent progression of advanced CKD.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WJ Urogenital system. Urology
WK Endocrine system. Endocrinology
Divisions: Clinical Support
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 31 Jan 2020 14:05
Last Modified: 31 Jan 2020 14:05
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2812

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