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Association of chronic kidney disease (CKD) and failure to monitor renal function with adverse outcomes in people with diabetes: a primary care cohort study

Abstract:

Background: Chronic kidney disease (CKD) is a known risk factor for cardiovascular events and all-cause mortality. We investigate the relationship between CKD stage, proteinuria, hypertension and these adverse outcomes in the people with diabetes. We also study the outcomes of people who did not have monitoring of renal function.

Methods: A cohort of people with type 1 and 2 diabetes (N = 35,502) from the Quality Improvement in Chronic Kidney Disease (QICKD) cluster randomised trial was followed up over 2.5 years. A composite of all-cause mortality, cardiovascular events, and end stage renal failure comprised the outcome measure. A multilevel logistic regression model was used to determine correlates with this outcome. Known cardiovascular and renal risk factors were adjusted for.

Results: Proteinuria and reduced estimated glomerular filtration rate (eGFR) were independently associated with adverse outcomes in people with diabetes. People with an eGFR <60 ml/min, proteinuria, and hypertension have the greatest odds ratio (OR) of adverse outcome; 1.58 (95% CI 1.36-1.83). Renal function was not monitored in 4460 (12.6%) people. Unmonitored renal function was associated with adverse events; OR 1.35 (95% CI 1.13-1.63) in people with hypertension and OR 1.32 (95% CI 1.07-1.64) in those without.

Conclusions: Proteinuria, eGFR < 60 ml/min, and failure to monitor renal function are associated with cardiovascular and renal events and mortality in people with diabetes.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/1471-2369-14-198

Authors


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Role:
Author
ORCID:
0000-0002-6833-9399
More by this author
Role:
Author
ORCID:
0000-0003-3325-6670
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Role:
Author
ORCID:
0000-0002-8267-5647
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0001-9738-6349


Publisher:
BioMed Central
Journal:
BMC Nephrology More from this journal
Volume:
14
Issue:
1
Article number:
198
Publication date:
2013-09-18
Acceptance date:
2013-05-23
DOI:
EISSN:
1471-2369
Pmid:
24047312


Language:
English
Keywords:
Pubs id:
1013848
Local pid:
pubs:1013848
Deposit date:
2024-06-06

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