Classification of longitudinal estimated glomerular filtration rate trajectories in Canadian adults with type 1 diabetes.

Autor: Favel K; Department of Pediatrics, University of California San Francisco, San Francisco, California, USA; Division of Nephrology, Benioff Children's Hospital, San Francisco, California, USA. Electronic address: kristen.favel@ucsf.edu., Bone JN; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada., Elliott T; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Division of Endocrinology, Gordon and Leslie Diamond Centre, Vancouver, British Columbia, Canada., Panagiotopoulos C; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Endocrinology & Diabetes Unit, British Columbia Children's Hospital, Vancouver, British Columbia, Canada., Mammen C; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Division of Nephrology, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2024 Nov; Vol. 38 (11), pp. 108864. Date of Electronic Publication: 2024 Sep 16.
DOI: 10.1016/j.jdiacomp.2024.108864
Abstrakt: Aims: Type 1 diabetes (T1D) increases the risk of chronic kidney disease (CKD) development. The aims of this study were to classify trajectories of estimated glomerular filtration rate (eGFR) in a cohort of Canadian adults with T1D, and to describe the risk factors associated with declining eGFR trajectories.
Methods: In this retrospective cohort of adults with T1D, data was collected between 1996 and 2020. CKD was defined as eGFR <60 mL/min/1.73 m 2 . Latent class mixed models were used to categorize eGFR trajectories. Multinomial logistic regression was used to identify factors associated with declining eGFR trajectories.
Results: In this study, 304 adults were analyzed, with baseline measurements at a median duration of T1D of 15.3 (5.4-24.2) years. Eight percent of the cohort developed CKD over a median duration of 24.3 (13.7-34.8) years. Four classes of longitudinal eGFR trajectories were identified, broadly categorized as steeply declining (SD1, SD2) and gradual declining (GD1, GD2). Female sex, poor glycemic control, elevated body mass index, and albuminuria were associated with a steeply declining trajectory.
Conclusion: In this cohort, four distinctive eGFR trajectories were identified, including a subtype with steeply declining eGFR. Given the complex nature of CKD progression, further prospective study of this model for identification of individuals at risk for CKD based on their trajectory of kidney function may support clinicians in their decision-making.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Constadina Panagiotopoulos reports financial support was provided by Juvenile Diabetes Research Foundation (JDRF) Centre of Excellence. Kristen Favel reports financial support was provided by University of British Columbia Faculty of Medicine Clinician Investigator Program. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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