Clinical outcome and risk factors for mortality in Chinese patients with diabetes on peritoneal dialysis: A 5-year clinical cohort study

Purpose: Subconjunctival hemorrhage (SCH) is usually a benign ocular disorder that causes painless, redness under the conjunctiva. However, since SCH and acute coronary syndrome (ACS) share many vascular risk factors, studies have suggested that these two disorders may be significantly associated with each other, and evaluate the concomitance of ACS in patients with SCH.Methods: This population-based cohort study, enrolled 35,260 Taiwanese patients, and used the Taiwan National Health Insurance Research Database to identify patients with ACS and SCH. Outcomes were compared between the with and without SCH groups. The study population was followed until the date of ACS onset, the date of withdrawal, death, or December 31st 2013, whichever came first.Results: Of the 85,925 patients identified with SCH between 1996 and 2013, 68,295 were excluded based on the study's exclusion criteria, and a total of 17,630 patients with SCH who were diagnosed by ophthalmologists between 2000 and 2012 were eligible for analysis. After 1:1 propensity score matching for 5-year age groups, gender, and the index year, the results showed that SCH was more common in the 40–59 age group (53.82%) and females (58.66%). As for the ACS-related risk factors, patients with diabetes mellitus (aHR = 1.58, 95% CI = [1.38, 1.81]), hypertension (aHR = 1.71, 95% CI = [1.49, 1.96]) and patients taking aspirin (aHR = 1.67, 95% CI = [1.47, 1.90]) had a notably higher risk of ACS. However, it was found that there were no significant differences in the occurrence of ACS between the non-SCH and SCH patients.Conclusion: This results of this study regarding the risk factors and epidemiology of SCH and ACS were in keeping with previously reported findings. However, the results revealed no significant association between SCH and ACS.

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Risk factors for early death in urgent‐start peritoneal dialysis patients: a multicenter retrospective cohort study

Therapeutic Apheresis and Dialysis ◽

10.1111/1744-9987.13781 ◽

2021 ◽

Author(s):

Lingfei Meng ◽

Liming Yang ◽

Xueyan Zhu ◽

Zhanshan Sun ◽

Xiaoxuan Zhang ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Peritoneal Dialysis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Early Death ◽

Dialysis Patients

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Determinants of Poor Glycemic Control in Patients with Kidney Transplants: A Single-Center Retrospective Cohort Study in Canada

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120922628 ◽

2020 ◽

Vol 7 ◽

pp. 205435812092262

Author(s):

Daniel Chan Chun Kong ◽

Ayub Akbari ◽

Janine Malcolm ◽

Mary-Anne Doyle ◽

Stephanie Hoar

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Peritoneal Dialysis ◽

Glycemic Control ◽

Kidney Transplant ◽

Deceased Donor ◽

Poor Glycemic Control ◽

Single Center ◽

Readmission Rates

Background: Kidney transplant immunosuppressive medications are known to impair glucose metabolism, causing worsened glycemic control in patients with pre-transplant diabetes mellitus (PrTDM) and new onset of diabetes after transplant (NODAT). Objectives: To determine the incidence, risk factors, and outcomes of both PrTDM and NODAT patients. Design: This is a single-center retrospective observational cohort study. Setting: The Ottawa Hospital, Ontario, Canada. Participant: A total of 132 adult (>18 years) kidney transplant patients from 2013 to 2015 were retrospectively followed 3 years post-transplant. Measurements: Patient characteristics, transplant information, pre- and post-transplant HbA1C and random glucose, follow-up appointments, complications, and readmissions. Methods: We looked at the prevalence of poor glycemic control (HbA1c >8.5%) in the PrTDM group before and after transplant and compared the prevalence, follow-up appointments, and rate of complications and readmission rates in both the PrTDM and NODAT groups. We determined the risk factors of developing poor glycemic control in PrTDM patients and NODAT. Student t-test was used to compare means, chi-squared test was used to compare percentages, and univariate analysis to determine risk factors was performed by logistical regression. Results: A total of 42 patients (31.8%) had PrTDM and 12 patients (13.3%) developed NODAT. Poor glycemic control (HbA1c >8.5%) was more prevalent in the PrTDM (76.4%) patients compared to those with NODAT (16.7%; P < .01). PrTDM patients were more likely to receive follow-up with an endocrinologist ( P < .01) and diabetes nurse ( P < .01) compared to those with NODAT. There were no differences in the complication and readmission rates for PrTDM and NODAT patients. Receiving a transplant from a deceased donor was associated with having poor glycemic control, odds ratio (OR) = 3.34, confidence interval (CI = 1.08, 10.4), P = .04. Both patient age, OR = 1.07, CI (1.02, 1.3), P < .01, and peritoneal dialysis prior to transplant, OR = 4.57, CI (1.28, 16.3), P = .02, were associated with NODAT. Limitations: Our study was limited by our small sample size. We also could not account for any diabetes screening performed outside of our center or follow-up appointments with family physicians or community endocrinologists. Conclusion: Poor glycemic control is common in the kidney transplant population. Glycemic targets for patients with PrTDM are not being met in our center and our study highlights the gap in the literature focusing on the prevalence and outcomes of poor glycemic control in these patients. Closer follow-up and attention may be needed for those who are at risk for worse glycemic control, which include older patients, those who received a deceased donor kidney, and/or prior peritoneal dialysis.

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Evaluation of Risk Factors for Major Amputation in Patients With Diabetes and Peripheral Artery Disease Receiving Antiplatelet Therapy　― Post Hoc Analysis of a Prospective Observational Multicenter Cohort Study (SEASON) ―

Circulation Journal ◽

10.1253/circj.cj-19-0088 ◽

2019 ◽

Vol 83 (9) ◽

pp. 1929-1936 ◽

Cited By ~ 1

Author(s):

Yukihito Higashi ◽

Tetsuro Miyata ◽

Hiroshi Shigematsu ◽

Hideki Origasa ◽

Masatoshi Fujita ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Major Amputation ◽

Peripheral Artery ◽

Multicenter Cohort Study ◽

Post Hoc Analysis ◽

Multicenter Cohort ◽

Patients With Diabetes ◽

Artery Disease ◽

Post Hoc

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408Albuminuria as a predictor of incident ischemic stroke and myocardial infarction in patients with type 2 diabetes but without cardiovascular disease: A Danish cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz747.0103 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M V Fangel ◽

P B Nielsen ◽

J K Kristensen ◽

T B Larsen ◽

T F Overvad ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Cohort Study ◽

Ischemic Stroke ◽

Cardiovascular Risk ◽

All Cause Mortality ◽

Patients With Diabetes

Abstract Background Risk stratification in patients with type 2 diabetes continues to be an important priority in the management of diabetes-related morbidity and mortality. International guidelines generally recognize patients with diabetes and cardiovascular disease as high-risk patients. Risk stratification is, however, more uncertain in diabetes patients without cardiovascular disease. Micro- and macroalbuminuria have previously been identified as predictors of cardiovascular events and mortality in general cohorts of diabetes patients. However, less is known about the predictive value of albuminuria in patients with diabetes but without established cardiovascular disease. Purpose We aimed to examine the association between albuminuria level and the risk of ischemic stroke, myocardial infarction, and all-cause mortality in patients with type 2 diabetes and without a diagnosis of cardiovascular disease. Methods We linked Danish nationwide registries to identify patients with type 2 diabetes and without cardiovascular disease from May 2005 through June 2015. Based on two consecutive measurements of the urinary albumin excretion rate or albumin-to-creatinine ratio patients were stratified in categories of normoalbuminuria, microalbuminuria, and macroalbuminuria. Patients were followed for the outcomes ischemic stroke, myocardial infarction, and all-cause mortality until December 31, 2015. Five-year risk of outcomes were presented as cumulative incidence functions (with death as a competing event). Associations between albuminuria level and incidence of ischemic stroke, myocardial infarction, and all-cause mortality were evaluated with Cox proportional hazard regression adjusted for cardiovascular risk factors. Results The study population included 78,841 patients with type 2 diabetes (44.7% females, mean age 63.2). When comparing patients with microalbuminuria to patients with normoalbuminuria in an age- and sex-adjusted analysis, we found hazard ratios (HRs) of 1.45 (95% CI: 1.24–1.69), 1.45 (95% CI: 1.24–1.70), and 1.50 (95% CI: 1.39–1.61) for ischemic stroke, myocardial infarction, and all-cause mortality, respectively. Furthermore, macroalbuminuria was associated with HRs of 2.05 (95% CI: 1.70–2.48), 2.25 (95% CI: 1.86–2.71), and 2.03 (95% CI: 1.85–2.23) for ischemic stroke, myocardial infarction, and all-cause mortality, respectively. Similar results were found after adjusting for cardiovascular risk factors. Conclusions In this nationwide cohort study of patients with type 2 diabetes but without cardiovascular disease, patients with micro- and macroalbuminuria had a higher risk of incident ischemic stroke, myocardial infarction, and all-cause mortality. This finding supports that patients with micro- or macroalbuminuria should be screened regularly and followed closely in clinical practice. Moreover, these findings suggest that patients with type 2 diabetes and micro- or macroalbuminuria may benefit from intensive vascular risk reduction.

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