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Risk Factors for Kidney Disease in Type 1 Diabetes
- Source :
- Diabetes Care
- Publication Year :
- 2019
- Publisher :
- American Diabetes Association, 2019.
-
Abstract
- OBJECTIVE In type 1 diabetes (T1D), the course of microalbuminuria is unpredictable and timing of glomerular filtration rate (GFR) loss is uncertain. Thus, there is a need to identify the risk factors associated with the development of more advanced stages of kidney disease through large, long-term systematic analysis. RESEARCH DESIGN AND METHODS Multivariable Cox proportional hazards models assessed the association of baseline and time-dependent glycemic and nonglycemic risk factors for incident macroalbuminuria and reduced estimated GFR (eGFR; defined as RESULTS Higher mean HbA1c (hazard ratio [HR] 1.969 per 1% higher level [95% CI 1.671–2.319]) and male sex (HR 2.767 [95% CI 1.951–3.923]) were the most significant factors independently associated with incident macroalbuminuria, whereas higher mean triglycerides, higher pulse, higher systolic blood pressure (BP), longer diabetes duration, higher current HbA1c, and lower mean weight had lower magnitude associations. For incident reduced eGFR, higher mean HbA1c (HR 1.952 per 1% higher level [95% CI 1.714–2.223]) followed by higher mean triglycerides, older age, and higher systolic BP were the most significant factors. CONCLUSIONS Although several risk factors associated with macroalbuminuria and reduced eGFR were identified, higher mean glycemic exposure was the strongest determinant of kidney disease among the modifiable risk factors. These findings may inform targeted clinical strategies for the frequency of screening, prevention, and treatment of kidney disease in T1D.
- Subjects :
- Adult
Blood Glucose
Male
medicine.medical_specialty
Time Factors
Adolescent
Endocrinology, Diabetes and Metabolism
Renal function
030209 endocrinology & metabolism
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Albuminuria
Humans
Diabetic Nephropathies
030212 general & internal medicine
Epidemiology/Health Services Research
Randomized Controlled Trials as Topic
Glycemic
Advanced and Specialized Nursing
Type 1 diabetes
business.industry
Proportional hazards model
Hazard ratio
medicine.disease
Diabetes Mellitus, Type 1
Hyperglycemia
Female
Kidney Diseases
Microalbuminuria
business
Follow-Up Studies
Glomerular Filtration Rate
Kidney disease
Subjects
Details
- ISSN :
- 19355548 and 01495992
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Diabetes Care
- Accession number :
- edsair.doi.dedup.....9f09f1cfd3b70c7ada25e42765da7f30