| Autor: |
Hirofumi Makino, Kengo Furuichi, Yuta Yamamura, Megumi Oshima, Tadashi Toyama, Takashi Wada, Masayuki Yamanouchi, Junichi Hoshino, Yoshifumi Ubara, Hitoshi Yokoyama, Miho Shimizu, Hiroshi Kitamura, Norihiko Sakai, Yasunori Iwata, Shinji Kitajima, Akinori Hara, Yukio Yuzawa, Yoshiki Suzuki, Hiroshi Sato, Noriko Uesugi, Yoshihiko Ueda, Shinichi Nishi, Tomoya Nishino, Kenichi Samejima, Kentaro Kohagura, Yugo Shibagaki, Seiichi Matsuo, Yuki Oba, Shusaku Matsuoka, Daisuke Ikuma, Hiroki Mizuno, Tatsuya Suwabe, Naoki Sawa |
| Jazyk: |
angličtina |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021) |
| Druh dokumentu: |
article |
| ISSN: |
2052-4897 |
| DOI: |
10.1136/bmjdrc-2021-002241 |
| Popis: |
Introduction Data on the association between longitudinal trajectory patterns of albuminuria and subsequent end-stage kidney disease (ESKD) and all-cause mortality in diabetic kidney disease (DKD) are sparse.Research design and methods Drawing on nationally representative data of 329 patients with biopsy-proven DKD and an estimated glomerular filtration rate above 30 mL/min/1.73 m2 at the time of biopsy, we used joint latent class mixed models to identify different 2-year trajectory patterns of urine albumin to creatinine ratio (UACR) and assessed subsequent rates of competing events: ESKD and all-cause death.Results A total of three trajectory groups of UACR were identified: ‘high-increasing’ group (n=254; 77.2%), ‘high-decreasing’ group (n=24; 7.3%), and ‘low-stable’ group (n=51; 15.5%). The ‘low-stable’ group had the most favorable risk profile, including the baseline UACR (median (IQR) UACR (mg/g creatinine): ‘low-stable’, 109 (50–138); ‘high-decreasing’, 906 (468–1740); ‘high-increasing’, 1380 (654–2502)), and had the least subsequent risk of ESKD and all-cause death among the groups. Although there were no differences in baseline characteristics between the ‘high-decreasing’ group and the ‘high-increasing’ group, the ‘high-decreasing’ group had better control over blood pressure, blood glucose, and total cholesterol levels during the first 2 years of follow-up, and the incidence rates of subsequent ESKD and all-cause death were lower in the ‘high-decreasing’ group compared with the ‘high-increasing’ group (incidence rate of ESKD (per 1000 person-years): 32.7 vs 77.4, p=0.014; incidence rate of all-cause death (per 1000 person-years): 0.0 vs 25.4, p=0.007).Conclusions Dynamic changes in albuminuria are associated with subsequent ESKD and all-cause mortality in DKD. Reduction in albuminuria by improving risk profile may decrease the risk of ESKD and all-cause death. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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