Incidence of Chronic Kidney Disease among Adults with Diabetes, 2015-2020.
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ABSTRACT:
SUBMITTER: Tuttle KR
PROVIDER: S-EPMC10701747 | biostudies-literature | 2022 Oct
REPOSITORIES: biostudies-literature
Publications
Incidence of Chronic Kidney Disease among Adults with Diabetes, 2015-2020.
Tuttle Katherine R KR Jones Cami R CR Daratha Kenn B KB Koyama Alain K AK Nicholas Susanne B SB Alicic Radica Z RZ Duru O Kenrik OK Neumiller Joshua J JJ Norris Keith C KC Ríos Burrows Nilka N Pavkov Meda E ME
The New England journal of medicine 20221001 15
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Project description:Purpose:Due to complex medical profiles, adults with neurodevelopmental disabilities (NDDs) may have a heightened risk for early development of chronic kidney disease (CKD) and accelerated CKD progression to advanced stages and kidney failure. The purpose of this study was to estimate the incidence rate of advanced CKD for adults with NDDs and compare the incidence rate to adults without NDDs. Patients and Methods:Data were used from the Optum Clinformatics® Data Mart to conduct this retrospective cohort study. The calendar year 2013 was used to identify eligible participants: individuals ?18 years of age and without advanced CKD. Participants were followed from 01/01/2014 to advanced CKD, loss to follow-up, death, or end of the study period (12/31/2017), whichever came first. Diagnostic, procedure, and diagnosis-related group codes identified NDDs (intellectual disabilities, cerebral palsy, autism spectrum disorders), incident cases of advanced CKD (CKD stages 4+), diabetes, cardiovascular diseases, and hypertension present in the year 2013. Crude incidence rates (IR) of advanced CKD and IR ratios (IRR), comparing adults with vs without NDDs (with 95% CI) were estimated. Then, Cox regression estimated the hazard ratio (HR and 95% CI) for advanced CKD, comparing adults with NDDs to adults without NDDs while adjusting for covariates. Results:Adults with NDDs (n=33,561) had greater crude IR of advanced CKD (IRR=1.32; 95% CI=1.24-1.42) compared to adults without NDDs (n=6.5M). The elevated rate of advanced CKD among adults with NDDs increased after adjusting for demographics (HR=2.19; 95% CI=2.04-2.34) and remained elevated with further adjustment for hypertension and diabetes (HR=2.01; 95% CI=1.87-2.15) plus cardiovascular disease (HR=1.84; 95% CI=1.72-1.97). Stratified analyses showed that the risk of advanced CKD was greater for all NDD subgroups. Conclusion:Study findings suggest that adults with NDDs have a greater risk of advanced CKD than do adults without NDDs, and that difference is not explained by covariates used in our analysis.
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Project description:Background & aimsAlthough dietary patterns have been linked to chronic diseases such as cardiovascular disease, sparse data are available for a relationship between dietary patterns and incident chronic kidney disease (CKD) in West Asian populations. The aim of this study was to evaluate the association of population-based dietary pattern with the risk of incident CKD after 6.1 years of follow-up.MethodsAt baseline, habitual dietary intakes of 1630 participants of the Tehran Lipid and Glucose Study (TLGS) who were free of CKD was assessed by a valid and reliable food-frequency questionnaire. The following three major dietary patterns were identified using a principal components analysis: Lacto-vegetarian dietary pattern, traditional Iranian dietary pattern, and high fat, high sugar dietary pattern. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease (MDRD) Study equation and CKD was defined as eGFR < 60 mL/min/1.73m2. Odds ratio (OR) using multivariable logistic regression was calculated for the association of incident CKD with the extracted dietary patterns.ResultsAfter adjusting for age, sex, smoking, total energy intake, physical activity, body mass index, diabetes, and hypertension the OR for participants in the highest compared with those in the lowest tertile of the lacto-vegetarian dietary pattern was 0.57 (95% confidence interval [CI]: 0.41 to 0.80, P-trend = 0.002). In contrast, the high fat, high sugar dietary pattern was positively associated with the incidence of CKD (OR for the third tertile compared with first tertile: 1.46; 95% CI: 1.03-2.09; P-trend = 0.036). Traditional Iranian dietary pattern was not associated with incident CKD.ConclusionThe high fat, high sugar dietary pattern was associated with significantly increased (46%) odds of incident CKD, whereas a lacto-vegetarian dietary pattern may be protective against the occurrence of CKD by 43%.
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Project description:ObjectivesWe used findings from the Global Burden of Disease 2015 study to update our previous publication on the burden of diabetes and chronic kidney disease due to diabetes (CKD-DM) during 1990-2015.MethodsWe extracted GBD 2015 estimates for prevalence, mortality, and disability-adjusted life years (DALYs) of diabetes (including burden of low vision due to diabetes, neuropathy, and amputations and CKD-DM for 22 countries of the EMR from the GBD visualization tools.ResultsIn 2015, 135,230 (95% UI 123,034-148,184) individuals died from diabetes and 16,470 (95% UI 13,977-18,961) from CKD-DM, 216 and 179% increases, respectively, compared to 1990. The total number of people with diabetes was 42.3 million (95% UI 38.6-46.4 million) in 2015. DALY rates of diabetes in 2015 were significantly higher than the expected rates based on Socio-demographic Index (SDI).ConclusionsOur study showed a large and increasing burden of diabetes in the region. There is an urgency in dealing with diabetes and its consequences, and these efforts should be at the forefront of health prevention and promotion.
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Project description:ObjectiveTo assess the prevalence and trends of chronic kidney disease (CKD) in Western Australia (WA) from 2010 to 2020 using linked pathology data.DesignA retrospective observational cohort study using linked de-identified data from WA pathology providers, hospital morbidity records and mortality records.SettingA Western Australian population-based study.ParticipantsAll individuals aged 18 years and older with at least one serum creatinine test.Primary outcome measureCKD status as determined by estimated glomerular filtration rate and urine albumin-creatinine ratio.ResultsAnalysing data from 2 501 188 individuals, there was a significant increase in age-sex standardised CKD prevalence from 4.7% in 2010 to 6.0% in 2020, with annual average percentage change of 3.0% (95% CI: 2.3% to 3.7%). Prevalence of CKD stages 3 and above was 4.8% in 2020. Higher CKD prevalence was observed in regional and remote areas compared with major cities, and among individuals in the most socioeconomically disadvantaged quintiles. Sensitivity analysis indicated minor impacts from data exclusions and methodological choices.ConclusionsCKD prevalence in WA has been steadily increasing, reflecting broader Australian trends. The study highlights significant disparities in CKD prevalence based on age, socioeconomic status and geographic remoteness.
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Project description:BackgroundThe prevalence of depression among patients with chronic kidney disease (CKD) is high and closely related to poor prognosis. However, the association between sleep onset time, sleep duration, and depression in CKD patients has not been thoroughly studied.MethodsThis study utilized cross-sectional data from CKD patients who participated in the National Health and Nutrition Examination Survey from 2015 to 2020, analyzing their sleep onset time, sleep duration, and Patient Health Questionnaire-Nine. Logistic regression models and restricted cubic spline models were used to explore the association between sleep onset time, sleep duration, and depression in CKD patients.ResultsA total of 2141 CKD patients aged 20 and above were included in this study, among whom 246 (11.5 %) had depression. Compared to those reporting optimal sleep onset (22:00-23:59) and sufficient sleep duration (7-8 h), CKD patients with late sleep onset (≥24:00) and either insufficient (<7 h) or excessive (≥9 h) sleep had a significantly higher risk of depression, with adjusted OR of 2.03 (95 % CI:1.29-3.19) and 2.07 (95 % CI:1.07-4.00), respectively. Additionally, the association between sleep onset time, sleep duration, and depression showed a U-shaped pattern, with the inflection point for sleep onset time at 23:00 and for sleep duration at 7.5 h.ConclusionInappropriate sleep onset time and sleep duration are significantly associated with depression in CKD patients. This association may be important to consider in clinical practice for the prevention and management of depressive symptoms in CKD patients.
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Project description:The objective was to estimate chronic kidney disease (CKD) incidence rates from prevalence and mortality data, and compare the estimates with observed (true) incidence rates in a well-characterized population with diabetes. Pima Indians aged 20 years and older with type 2 diabetes were followed from 1982 through 2007. CKD was defined by estimated GFR (eGFR) <60 ml/min/1.72 m2 or albumin-to-creatinine ratio (ACR) ≥30 mg/g. True CKD incidence and mortality rates were computed for the whole study period, and prevalence for the intervals 1982-1994 and 1995-2007. Estimated age-sex stratified CKD incidence rates were computed using illness-death models of the observed prevalences, and of the whole-period mortality rate ratio of CKD to non-CKD persons. Among 1201 participants, 616 incident events of CKD occurred during a median follow-up of 5.6 years. Observed CKD prevalence was 56.9% (95%CI 53.7-60.0) and 48.0% (95%CI 45.2-50.8) in women; 54.0% (95%CI 49.9-58.1) and 49.6% (95%CI 46.0-53.3) in men, across the two periods. Mortality rate was 2.5 (95%CI 1.9-3.3) times as high in women with CKD and 1.6 (95%CI 1.3-2.1) times as high in men with CKD, compared to women or men without CKD. In women, estimated CKD incidence increased linearly from 25.6 (95%CI 4.2-53.0) to 128.6 (95%CI 77.1-196.6) with each 5-year age group up to 69 years, and to 99.8 (95%CI 38.7-204.7) at age ≥70. In men, estimated CKD incidence increased form 28.5 (95%CI 3.8-71.2) at age 20-24 years to 118.7 (95%CI 23.6-336.7) at age ≥70. Age-sex-stratified estimated incidence reflected the magnitude and directional trend of the true incidence and were similar to the true incidence rates (p>0.05 for difference) except for age 20-24 in women (p = 0.008) and age 25-29 in men (p = 0.002). In conclusion, the estimated and observed incidence rates of CKD agree well over 25 years of observation in this well characterized population with type 2 diabetes.
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Project description:BackgroundIt is known that risk of chronic kidney disease (CKD) is elevated in patients with diabetes mellitus but it is not clear whether the risk is also elevated with impaired glucose tolerance (IGT). If the risk is increased, it is not known if this is confined to people with IGT who progress to type 2 diabetes (T2DM). The purpose of this systematic review is to determine the relative risk of CKD in young adults (aged 18 to 40 years) with IGT (exposed group) compared to those without glycaemic abnormality (comparator group).Methods/designThe following electronic databases will be systematically searched from inception to January 2015 for relevant studies: CINAHL, EMBASE, MEDLINE, PubMed, Cochrane libraries and grey literature. Two independent reviewers will screen search results, extract data, select studies for inclusion and assess their quality. Studies including young adults (aged 18 to 40 years) with IGT containing any of the following CKD markers will be included: estimated glomerular filtration rate (eGFR), albumin creatinine ratio (ACR), protein creatinine ratio (PCR), serum creatinine (SCr) and creatinine clearance (CrCl) levels. Studies at any time period after diagnosis of IGT and with any length of follow-up will be included. The proportion of IGT participants reporting each outcome will be documented. Relative risks (RR) and odds ratios (OR) will be extracted or calculated from raw data. If possible, study results will be combined in a meta-analysis.DiscussionThe results of this comprehensive review will establish the evidence for the association between IGT and the risk of developing CKD in young adults (aged 18 to 40 years).Systematic review registrationPROSPERO CRD42014007081.
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