Death, end-stage renal disease and renal function decline in patients with diabetic nephropathy in French cohorts of type 1 and type 2 diabetes
Aims/hypothesis Microvascular complications are a common feature of diabetes but additional research is needed regarding diabetic nephropathy endpoints in type 1 and type 2 diabetes. Methods We compared 277 type 1 diabetes patients with 942 type 2 diabetes patients, with clinical proteinuria and no end-stage renal disease (ESRD) at baseline, prospectively followed for death, ESRD and decline in estimated glomerular filtration rate (eGFR, all available measures). Results The incidence rate of death was 67.0 (95% CI 59.2, 74.8) vs 24.6 (95% CI, 19.0, 30.2) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for death was greater for type 2 diabetes patients (HR 3.423; 95% CI, 2.501, 4.683; p < 0.0001), but the difference did not persist after adjustment for age ($ HR_{age-adj} $ 0.859; 95% CI 0.581, 1.269; p = 0.445). The incidence rate of ESRD was 18.4 (95% CI 14.2, 22.5) vs 47.1 (95% CI 38.4, 55.9) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for ESRD was lower in type 2 diabetes (HR 0.399; 95% CI 0.287, 0.554; p < 0.0001), but the difference did not persist after adjustment for sex, age and baseline serum creatinine ($ HR_{adj} $ 0.989; 95% CI 0.597, 1.639; p = 0.965). In a mixed linear model, eGFR decline was not significantly different in type 2 vs type 1 diabetes (difference in slope −0.19 [0.28] ml $ min^{−1} $ 1.73 $ m^{−2} $ $ year^{−1} $; p = 0.512). Conclusions/interpretation In diabetic nephropathy, once baseline risk factors were taken into account the risk for death, ESRD and renal function decline did not significantly differ between type 1 diabetes and type 2 diabetes..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
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| Enthalten in: |
Diabetologia - 59(2015), 1 vom: 20. Okt., Seite 208-216 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hadjadj, Samy [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Death |
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| RVK: |
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| Anmerkungen: |
© Springer-Verlag Berlin Heidelberg 2015 |
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| doi: |
10.1007/s00125-015-3785-3 |
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| 520 | |a Aims/hypothesis Microvascular complications are a common feature of diabetes but additional research is needed regarding diabetic nephropathy endpoints in type 1 and type 2 diabetes. Methods We compared 277 type 1 diabetes patients with 942 type 2 diabetes patients, with clinical proteinuria and no end-stage renal disease (ESRD) at baseline, prospectively followed for death, ESRD and decline in estimated glomerular filtration rate (eGFR, all available measures). Results The incidence rate of death was 67.0 (95% CI 59.2, 74.8) vs 24.6 (95% CI, 19.0, 30.2) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for death was greater for type 2 diabetes patients (HR 3.423; 95% CI, 2.501, 4.683; p < 0.0001), but the difference did not persist after adjustment for age ($ HR_{age-adj} $ 0.859; 95% CI 0.581, 1.269; p = 0.445). The incidence rate of ESRD was 18.4 (95% CI 14.2, 22.5) vs 47.1 (95% CI 38.4, 55.9) per 1,000 patient-years, in type 2 diabetes and type 1 diabetes, respectively. Unadjusted risk for ESRD was lower in type 2 diabetes (HR 0.399; 95% CI 0.287, 0.554; p < 0.0001), but the difference did not persist after adjustment for sex, age and baseline serum creatinine ($ HR_{adj} $ 0.989; 95% CI 0.597, 1.639; p = 0.965). In a mixed linear model, eGFR decline was not significantly different in type 2 vs type 1 diabetes (difference in slope −0.19 [0.28] ml $ min^{−1} $ 1.73 $ m^{−2} $ $ year^{−1} $; p = 0.512). Conclusions/interpretation In diabetic nephropathy, once baseline risk factors were taken into account the risk for death, ESRD and renal function decline did not significantly differ between type 1 diabetes and type 2 diabetes. | ||
| 650 | 4 | |a Death | |
| 650 | 4 | |a Diabetic complications | |
| 650 | 4 | |a Diabetic nephropathy | |
| 650 | 4 | |a Renal function decline | |
| 650 | 4 | |a Type 1 diabetes | |
| 650 | 4 | |a Type 2 diabetes | |
| 700 | 1 | |a Cariou, Bertrand |4 aut | |
| 700 | 1 | |a Fumeron, Frederic |4 aut | |
| 700 | 1 | |a Gand, Elise |4 aut | |
| 700 | 1 | |a Charpentier, Guillaume |4 aut | |
| 700 | 1 | |a Roussel, Ronan |4 aut | |
| 700 | 1 | |a Kasmi, Ahmed-Amine |4 aut | |
| 700 | 1 | |a Gautier, Jean-François |4 aut | |
| 700 | 1 | |a Mohammedi, Kammel |4 aut | |
| 700 | 1 | |a Gourdy, Pierre |4 aut | |
| 700 | 1 | |a Saulnier, Pierre-Jean |4 aut | |
| 700 | 1 | |a Feigerlova, Eva |4 aut | |
| 700 | 1 | |a Marre, Michel |4 aut | |
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