scholarly journals The Relationship between AKI and CKD in Patients with Type 2 Diabetes: An Observational Cohort Study

2020 ◽  
Vol 32 (1) ◽  
pp. 138-150 ◽  
Author(s):  
Simona Hapca ◽  
Moneeza K. Siddiqui ◽  
Ryan S.Y. Kwan ◽  
Michelle Lim ◽  
Shona Matthew ◽  
...  

BackgroundThere are few observational studies evaluating the risk of AKI in people with type 2 diabetes, and even fewer simultaneously investigating AKI and CKD in this population. This limits understanding of the interplay between AKI and CKD in people with type 2 diabetes compared with the nondiabetic population.MethodsIn this retrospective, cohort study of participants with or without type 2 diabetes, we used electronic healthcare records to evaluate rates of AKI and various statistical methods to determine their relationship to CKD status and further renal function decline.ResultsWe followed the cohort of 16,700 participants (9417 with type 2 diabetes and 7283 controls without diabetes) for a median of 8.2 years. Those with diabetes were more likely than controls to develop AKI (48.6% versus 17.2%, respectively) and have preexisting CKD or CKD that developed during follow-up (46.3% versus 17.2%, respectively). In the absence of CKD, the AKI rate among people with diabetes was nearly five times that of controls (121.5 versus 24.6 per 1000 person-years). Among participants with CKD, AKI rate in people with diabetes was more than twice that of controls (384.8 versus 180.0 per 1000 person-years after CKD diagnostic date, and 109.3 versus 47.4 per 1000 person-years before CKD onset in those developing CKD after recruitment). Decline in eGFR slope before AKI episodes was steeper in people with diabetes versus controls. After AKI episodes, decline in eGFR slope became steeper in people without diabetes, but not among those with diabetes and preexisting CKD.ConclusionsPatients with diabetes have significantly higher rates of AKI compared with patients without diabetes, and this remains true for individuals with preexisting CKD.

2021 ◽  
Vol 10 (18) ◽  
pp. 4098
Author(s):  
Stefan Zechmann ◽  
Leana Hotz ◽  
Stefania Di Gangi ◽  
Klaus Baumgartl ◽  
Andreas Plate ◽  
...  

We analysed the effects of Swiss national lockdown due to the COVID-19 pandemic on the glycaemic control in patients with diabetes mellitus. In a retrospective observational cohort study with observation period 16 December 2018–27 July 2020, we included tertiary care patients with diabetes and at least one glycated haemoglobin A1c (HbA1c) measurement before and after the lockdown beginning. Main outcome measure was change in HbA1c after the lockdown. We included 1078 patients (86% diabetes type 2) with a mean HbA1c of 55.63 mmol/mol (7.24%). Glycaemic control was susceptible to seasonal changes with higher mean HbA1c in winter as compared to spring (57.49 mmol/mol (7.41%) vs. 55.52 mmol/mol (7.23%), p = 0.013). The lockdown did not affect the mean HbA1c values of all patients. However, we found a higher proportion of type 2 diabetes patients with a worsening HbA1c after the lockdown as compared to the year before (32% vs. 22.9%, p = 0.02). In a mixed-model regression multivariable analysis, inappropriate alcohol intake and hypothyroidism were associated with an increase in HbA1c after the lockdown. In conclusion, the national lockdown had no effect on overall mean HbA1c values but affected a proportion of type 2 diabetes patients with worsening HbA1c, whose individual risk factors were identified.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 131-OR
Author(s):  
VASILEIOS LIAKOPOULOS ◽  
ANN-MARIE SVENSSON ◽  
INGMAR NASLUND ◽  
BJORN ELIASSON

2011 ◽  
Vol 10 (1) ◽  
pp. 18 ◽  
Author(s):  
Angel Rodriguez ◽  
Jesus Reviriego ◽  
Vasilios Karamanos ◽  
Franciso J del Canizo ◽  
Nikolaos Vlachogiannis ◽  
...  

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