scholarly journals Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ayami Kajiwara ◽  
Ayana Kita ◽  
Junji Saruwatari ◽  
Hiroko Miyazaki ◽  
Yuki Kawata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Sex Differences ◽  
Renal Dysfunction ◽  
Ldl Cholesterol ◽  
Early Stage ◽  
Interactive Effects ◽  
Renal Function Decline ◽  
Egfr Decline

Aims. We aimed to investigate the sex differences in the renal function decline among patients with type 2 diabetic mellitus (T2DM), focusing on the differences in the risk factors at early stage of renal dysfunction.Methods. A clinic-based retrospective longitudinal study (follow-up duration:8.1±1.4years) was conducted to assess the sex differences in the annual estimated glomerular filtration rate (eGFR) change in 344 (247 male and 97 female) Japanese T2DM patients. The sex differences in the risk factors of annual eGFR decline were subjected to linear regression analyses.Results. The mean annual eGFR change was-3.5±2.7%/year in females and-2.0±2.2%/year in males (P<0.001). Baseline retinopathy and proteinuria were significantly associated with a larger eGFR decline, irrespective of sex, while HbA1c and LDL-cholesterol levels were significantly associated with an eGFR decline in females only. Interactive effects were observed between sex and the HbA1c, LDL-cholesterol, retinopathy, or proteinuria levels on the annual eGFR decline.Conclusions. The increased susceptibility to poor metabolic control seemed to contribute to a higher risk of renal dysfunction in females with T2DM. Our study highlights the importance of aggressive therapeutic intervention to improve metabolic profiles at early stage, especially in females.

scholarly journals Hyperglycemia Regulated Circulating MicroRNAs and Their Effects on Renal Function Decline in Type 2 Diabetes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A414-A414
Author(s):  
Hiroki Kobayashi ◽  
Eiichiro Satake ◽  
Andrezej S Krolewski
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Signaling Pathway ◽  
Mapk Pathway ◽  
Ras Signaling ◽  
Bioinformatics Analyses ◽  
Renal Function Decline ◽  
Function Discovery ◽  
Egfr Decline

Abstract Background: It has been reported that microRNAs (miRNAs) play an important role in the pathogenesis of diabetic complications. We aimed to search for circulating miRNA that were associated with hyperglycemia in type 2 diabetes and examine their effects on renal function decline. Methods: Using the next-generation sequencing-based HTG EdgeSeq miRNA platform, a total of 2,083 miRNAswere measured in baseline plasma specimens obtained from73 subjects with type 2 diabetes (T2D) and normal renal function (discovery panel) and 136 subjects with T2D and impaired renal function (replication panel). Subjects in both panels were followed for 6–12 years to determine eGFR decline. Results: We identified 11 candidate miRNAsthat were strongly associated with elevated levels of glycated hemoglobin (HbA1c) in both screening and replication panels. Using bioinformatics analyses, we found that the candidate miRNAs targeted proteins of 6 pathways (the Ras signaling pathway, Signaling pathways regulating pluripotency of stem cells, the MAPK pathway, Glutamatergic synapse, the Rap 1 signaling pathway, and the AMPK signaling pathway). Importantly, 4 of these 11 miRNAs were significantly associated with risk of renal function decline. Conclusion: There were few previous reports about the association between circulating miRNAs, hyperglycemia, and diabetic kidney disease in T2D. The present study comprehensively examined and identified hyperglycemia-regulated miRNAs in human samples. Our finding are novel in that circulatingmiRNAsregulated by hyperglycemia are associated with risk of eGFR decline in T2D.

scholarly journals Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe

2021 ◽  
Vol 9 (1) ◽  
pp. e002125
Author(s):  
Tomás P Griffin ◽  
Paula M O'Shea ◽  
Andrew Smyth ◽  
Md Nahidul Islam ◽  
Deirdre Wall ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Kidney Disease ◽  
Northern Europe ◽  
Rapid Decline ◽  
Renal Function Decline ◽  
Diabetes Center ◽  
Egfr Decline

IntroductionThis study aimed to determine the prevalence of diabetic kidney disease (DKD) and rapid renal function decline and to identify indices associated with this decline among adults attending a diabetes center in Northern Europe.Research design and methodsThis is a retrospective cohort study of 4606 patients who attended a diabetes center in Ireland between June 2012 and December 2016. Definition/staging of chronic kidney disease used the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 classification based on data from the most recently attended appointment. Relevant longitudinal trends and variabilities were derived from serial records prior to index visit. Rapid renal function decline was defined based on per cent and absolute rates of estimated glomerular filtration rate (eGFR) change. Multiple linear regression was used to explore the relationships between explanatory variables and per cent eGFR change.Results42.0% (total), 23.4% (type 1 diabetes), 47.9% (type 2 diabetes) and 32.6% (other diabetes) had DKD. Rapid decline based on per cent change was more frequent in type 2 than in type 1 diabetes (32.8% vs 14.0%, p<0.001). Indices independently associated with rapid eGFR decline included older age, greater number of antihypertensives, higher log-normalized urine albumin to creatinine ratio (LNuACR), serum alkaline phosphatase, thyroid stimulating hormone, variability in systolic blood pressure and variability in LNuACR, lower glycated hemoglobin, high-density lipoprotein cholesterol and diastolic blood pressure, and lack of ACE inhibitor/angiotensin receptor blocker prescription.ConclusionsDKD (using the KDIGO 2012 classification) and rapid eGFR decline were highly prevalent among adults attending a hospital-based diabetes clinic in a predominantly Caucasian Northern European country. The burden was greater for adults with type 2 diabetes. Expected as well as potentially novel clinical predictors were identified.

scholarly journals Estimated 24 h Urinary Sodium-to-Potassium Ratio Is Related to Renal Function Decline: A 6-Year Cohort Study of Japanese Urban Residents

2020 ◽  
Vol 17 (16) ◽  
pp. 5811
Author(s):  
Hiroko Hattori ◽  
Aya Hirata ◽  
Sachimi Kubo ◽  
Yoko Nishida ◽  
Miki Nozawa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Early Stage ◽  
Urban Residents ◽  
Normal Range ◽  
Multivariable Logistic Regression Model ◽  
Renal Function Decline ◽  
Increased Risk ◽  
Egfr Decline

The effect of the sodium-to-potassium ratio (Na/K) on renal function within the clinically normal range of renal function are limited. We investigated the effects of an estimated 24 h urinary Na/K (e24hUNa/K) on a 6-year renal function decline among 927 urban Japanese community dwellers with no history of cardiovascular diseases and medication for hypertension, diabetes, or dyslipidemia. We partitioned the subjects into quartiles according to the e24hUNa/K. The estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD/EPI) formula and renal function decline was defined as an absolute value at or above the third quartile of the eGFR decline rate. A multivariable logistic regression model was used for estimation. Compared with the first quartile of the e24hUNa/K, multivariable-adjusted odds ratios (ORs) for eGFR decline in the second, third, and fourth quartiles were 0.96 (95% confidence interval: 0.61–1.51), 1.06 (0.67–1.66), and 1.65 (1.06–2.57), respectively. These results were similar when the simple spot urine Na/K ratio was used in place of the e24hUNa/K. Apparently healthy urban residents with an almost within normal range mean baseline eGFR and high e24hUNa/K ratios had an increased risk for a future decline in renal function. Reducing the Na/K ratio may be important in the prevention of chronic kidney disease in its early stage.

scholarly journals PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)

2020 ◽  
Vol 9 (10) ◽  
pp. 3212
Author(s):  
Kirsten E. Peters ◽  
Jialin Xu ◽  
Scott D. Bringans ◽  
Wendy A. Davis ◽  
Timothy M.E. Davis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
High Risk ◽  
Low Risk ◽  
Moderate Risk ◽  
Renal Function Decline ◽  
Assessment Study ◽  
Cardiovascular Assessment ◽  
Egfr Decline

The ability of current tests to predict chronic kidney disease (CKD) complicating diabetes is limited. This study investigated the prognostic utility of a novel blood test, PromarkerD, for predicting future renal function decline in individuals with type 2 diabetes from the CANagliflozin CardioVascular Assessment Study (CANVAS). PromarkerD scores were measured at baseline in 3568 CANVAS participants (n = 1195 placebo arm, n = 2373 canagliflozin arm) and used to predict incident CKD (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 during follow-up in those above this threshold at baseline) and eGFR decline ≥30% during the 4 years from randomization. Biomarker concentrations (apolipoprotein A-IV (apoA4), CD5 antigen-like (CD5L/AIM) and insulin-like growth factor-binding protein 3 (IGFBP3) measured by mass spectrometry were combined with clinical data (age, serum high-density lipoprotein (HDL)-cholesterol, eGFR) using a previously defined algorithm to provide PromarkerD scores categorized as low-, moderate- or high-risk. The participants (mean age 63 years, 33% females) had a median PromarkerD score of 2.9%, with 70.5% categorized as low-risk, 13.6% as moderate-risk and 15.9% as high-risk for developing incident CKD. After adjusting for treatment, baseline PromarkerD moderate-risk and high-risk scores were increasingly prognostic for incident CKD (odds ratio 5.29 and 13.52 versus low-risk, respectively; both p < 0.001). Analysis of the PromarkerD test system in CANVAS shows the test can predict clinically significant incident CKD in this multi-center clinical study but had limited utility for predicting eGFR decline ≥30%.

500-P: Renal Function Decline and the Related Risk Factors in a Cohort of Beijing Community Diabetes Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 500-P
Author(s):  
MINGXIA YUAN ◽  
SHENYUAN YUAN ◽  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Renal Function Decline ◽  
Related Risk

scholarly journals Experts’ opinion on the detection and management of prediabetes in Lebanon

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110294
Author(s):  
Emile Andari ◽  
Paola Atallah ◽  
Sami Azar ◽  
Akram Echtay ◽  
Selim Jambart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preliminary Report ◽  
Early Stage ◽  
National Guidelines ◽  
Lifestyle Modifications ◽  
Multiple Tests ◽  
Lebanese Population ◽  
To Come ◽  
Near Future

Given that the complications of type 2 diabetes can start at an early stage, early detection and appropriate management of prediabetes are essential. We aimed to develop an expert opinion on prediabetes in Lebanon to pave the way for national guidelines tailored for the Lebanese population in the near future. A panel of seven diabetes experts conducted a thorough literature review and discussed their opinions and experiences before coming up with a set of preliminary recommendations for the detection and management of prediabetes in Lebanon. Lebanese physicians employ multiple tests for the diagnosis of prediabetes and no national cut-off values exist. The panel agreed that prediabetes screening should be focused on patients exceeding 45 years of age with otherwise no risk factors and on adults with risk factors. The panel reached that fasting plasma glucose (FPG) and HbA1c should be used for prediabetes diagnosis in Lebanon. FPG values of 100–125 mg/dL or HbA1c values of 5.7%–6.4% were agreed upon as indicative of prediabetes. For the management of prediabetes, a three-step approach constituting lifestyle modifications, pharmacological treatment and bariatric surgery is recommended. There should be more focus on research on prediabetes in Lebanon. This preliminary report will be further discussed with the Lebanese Society of Endocrinology, Diabetes and Lipids in 2021 in order to come up with the first Lebanese national guidelines for the detection and management of prediabetes in Lebanon.

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