Renal Function Following Fluorescein Angiography in Diabetic Patients With Chronic Kidney Disease

AbstractAssociations between hepatitis C virus (HCV) and chronic kidney disease (CKD) have been reported; however, differences of renal progression between general and CKD population remain to be elucidated in prospective studies. A total of 1179 participants, who have tested for anti-HCV antibody, were enrolled and prospectively followed for 3 years. The risks associated with HCV infection, in terms of incidence of CKD, annual estimated glomerular filtration rate (eGFR) changes and 50% decline of eGFR at 3-year from baseline, were compared between normal renal function subjects and CKD patients. Overall, 111 of 233 (47.6%) CKD patients and 167 of 946 (17.7%) non-CKD subjects had HCV infection. The crude incidence rates of CKD were 226.9 per 1000 person-years and 14.8 per 1000 person-years in in HCV and non-HCV infected patients, respectively. The adjusted hazard ratio of HCV infection for incident CKD was 7.9 (95% CI 5–12.7). The HCV-infected normal renal function subjects were independently associated with increased risks of eGFR decline in the 1-year, 2-year and 3-year, respectively. The risk associations remained significant in 50% decline of eGFR at 3 years models and in different subgroup analyses. The increases of risks of eGFR decline were also notorious among overall HCV-infected CKD patients. However, the risk associations were less prominent in subgroup analyses (elderly, women and diabetic patients). The findings highlighted the importance of viral diagnosis with not only prognostic but also public health implications for preserving kidney function.

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The Effect of Renal Dysfunction on Circulating Sclerostin Level in Patients with Type 2 Diabetes

International Journal of Endocrinology ◽

10.1155/2014/715908 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Se Hwa Kim ◽

Soo Young Yoon ◽

Sung-Kil Lim ◽

Yumie Rhee

Keyword(s):

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Renal Dysfunction ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Cross Sectional ◽

Sclerostin Level

Objective. Sclerostin is a Wnt inhibitor produced specifically by osteocytes. However, it is not currently clear whether renal dysfunction has an effect on circulating sclerostin level in patients with type 2 diabetes. The aim of the study was to evaluate this relationship. Design and Patients. We conducted a cross-sectional observational study of 302 type 2 diabetic patients with or without chronic kidney disease. Serum sclerostin level was analyzed by ELISA, and renal function was assessed by estimated glomerular filtration rate (eGFR) using chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Results. There was a strong correlation between sclerostin level with renal function presented as serum creatinine (r=0.745, P<0.001) and eGFR (r=-0.590, P<0.001). Serum sclerostin level was significantly higher in patients with CKD-G3 stage than those with CKD-G1/2 stages after adjusting for age, sex, and BMI (P=0.011). Patients with CKD-G4/5 stages had dramatically increased level of circulating sclerostin. Multiple regression analyses found that age, sex, and eGFR were independent determining factors for circulating sclerostin level. Conclusion. Our data showed that serum sclerostin levels start to increase in diabetic patients with CKD-G3 stage. Further studies are needed to establish the potential role of elevated sclerostin in diabetic patients with CKD.

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MO235EFFECT OF OMEGA-3 POLYUNSATURATED FATTY ACID SUPPLEMENTATION ON GLYSEMIC CONTROL AND RENAL FUNCTION IN TYPE 2 DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab092.00113 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Mehmet Usta ◽

Alpaslan Ersoy ◽

Canan Ersoy ◽

Yavuz Ayar ◽

Gultekin Goksel ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Diabetic Patients ◽

Omega 3 ◽

Short Term ◽

Type 2 Diabetic Patients ◽

Pufa Supplementation ◽

Type 2 Diabetic

Abstract Background and Aims The aim of this study was to evaluate the short-term effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) supplementation on glycemic control and renal function in type 2 diabetic patients with chronic kidney disease. Method Twenty-five diabetic patients received medication containing 2 g/day n-3 PUFA orally in addition to standard treatments. Their estimated glomerular filtration rates (eGFR) were <80 mL/min/1.73 m2. Biochemical values were evaluated before and 3 months after treatment. Results After three months of supplementation, the changes in serum creatinine, uric acid, eGFR and urinary albumin excretion levels did not reach statistical significance. There was no difference between serum glucose, HbA1C and lipid profile values before and after the n-3 PUFA supplementation in patients. Only serum albumin significantly increased from 4.10±0.26 to 4.28±0.31 g/dL (p=0.016), and systolic blood pressure decreased from 121.4±14.5 to 116.6±14.9 mmHg (p=0.001). Conclusion Short-term n-3 PUFA supplementation did not affect renal function and glycemic control in patients with type 2 diabetes with chronic kidney disease.

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The prevalence of chronic kidney disease and screening of renal function in type 2 diabetic patients in Finnish primary healthcare

Primary Care Diabetes ◽

10.1016/j.pcd.2020.05.005 ◽

2020 ◽

Vol 14 (6) ◽

pp. 639-644

Author(s):

Maria Hagnäs ◽

Henry Sundqvist ◽

Jari Jokelainen ◽

Andrea Tumminia ◽

Federica Vinciguerra ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Primary Healthcare ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

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Serum Neutrophil Gelatinase-Associated Lipocalin as a Marker of Renal Function in Non-Diabetic Patients with Stage 2–4 Chronic Kidney Disease

Renal Failure ◽

10.1080/08860220802134607 ◽

2008 ◽

Vol 30 (6) ◽

pp. 625-628 ◽

Cited By ~ 51

Author(s):

Jolanta Malyszko ◽

Hanna Bachorzewska-Gajewska ◽

Ewa Sitniewska ◽

Jacek S. Malyszko ◽

Boguslaw Poniatowski ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Diabetic Patients ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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Prevalence of Hyperkalemia in Diabetic and Non-Diabetic Patients with Chronic Kidney Disease: A Nested Case-Control Study

American Journal of Nephrology ◽

10.1159/000442393 ◽

2015 ◽

Vol 42 (5) ◽

pp. 351-360 ◽

Cited By ~ 16

Author(s):

Charalampos Loutradis ◽

Panagiota Tolika ◽

Alexandra Skodra ◽

Afroditi Avdelidou ◽

Pantelis A. Sarafidis

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Case Control Study ◽

Case Control ◽

Diabetic Patients ◽

Sodium Polystyrene Sulfonate ◽

Stage 4 ◽

Nested Case Control ◽

Control Study

Background: Hyperkalemia is a potentially life-threatening disorder, usually complicating chronic kidney disease (CKD). Factors superimposed to reduced renal function are further elevating hyperkalemia risk, but their contribution is not fully elucidated. This study aimed to compare the prevalence of hyperkalemia in diabetic and non-diabetic patients with CKD. Methods: This is a nested case-control study of 180 type-2 diabetic and 180 non-diabetic patients with CKD followed in a Nephrology outpatient clinic, matched for gender, age and estimated glomerular filtration rate. Type-1 diabetes or end-stage renal disease patients were excluded. Prevalence of hyperkalemia was defined as potassium >5 mEq/l or use of sodium polystyrene sulfonate, and further by potassium >5, ≥5.2 and ≥5.5 mEq/l. It was calculated in both groups in whole and CKD stages separately. Univariate and multivariate logistic regression analysis were conducted to identify factors associated with hyperkalemia. Results: The prevalence of hyperkalemia was higher in diabetic CKD patients (27.2 vs. 20%, p = 0.107) and remained around 30% higher with all secondary definitions used, but never reached statistical significance. In Stage 2, no difference was noted (8.7 vs. 17.4%, p = 0.665); in Stage 3, it was significantly higher in diabetics (28.6 vs. 17.5%, p = 0.036); and in Stage 4, it was equally high in both groups (35.5 vs. 32.3%, p = 0.788). In multivariate analysis, Stage 4 CKD (OR 4.535, 95% CI 1.561-13.173), use of angiotensin-converting enzyme inhibitors (ACEIs; OR 2.228, 95% CI 1.254-3.958) and smoking (OR 2.254, 95% CI 1.218-4.171) were independently associated with hyperkalemia. Conclusions: Diabetes mellitus was found to elevate the prevalence of hyperkalemia only in CKD Stage 3 patients (moderately impaired renal function). Advanced CKD at Stage 4 and ACEIs are major determinants of hyperkalemia occurrence.

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Effect of renal function on serum concentration of 1,5-anhydroglucitol in type 2 diabetic patients in chronic kidney disease stages I-III: A comparative study with HbA1c and glycated albumin

Journal of Diabetes ◽

10.1111/1753-0407.12354 ◽

2016 ◽

Vol 8 (5) ◽

pp. 712-719 ◽

Cited By ~ 7

Author(s):

Christoph Hasslacher ◽

Felix Kulozik

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Serum Concentration ◽

Glycated Albumin ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Disease Stages ◽

Type 2 Diabetic

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Liraglutide preserves renal function in overweight diabetic patients with stage 3 chronic kidney disease

European Journal of Internal Medicine ◽

10.1016/j.ejim.2017.07.020 ◽

2017 ◽

Vol 44 ◽

pp. e28-e29 ◽

Cited By ~ 4

Author(s):

María Dolores García de Lucas ◽

Beatriz Aviles Bueno ◽

Julián Olalla Sierra

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Diabetic Patients

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Emergence of T cell immunosenescence in diabetic chronic kidney disease

Immunity & Ageing ◽

10.1186/s12979-020-00200-1 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Yen-Ling Chiu ◽

Wan-Chuan Tsai ◽

Ruo-Wei Hung ◽

I-Yu Chen ◽

Kai-Hsiang Shu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Renal Failure ◽

T Cells ◽

Renal Function ◽

T Cell ◽

Kidney Disease ◽

Glucose Control ◽

Diabetic Patients

Abstract Background Type 2 diabetes is an important challenge given the worldwide epidemic and is the most important cause of end-stage renal disease (ESRD) in developed countries. It is known that patients with ESRD and advanced renal failure suffer from immunosenescence and premature T cell aging, but whether such changes develop in patients with less severe chronic kidney disease (CKD) is unclear. Method 523 adult patients with type 2 diabetes were recruited for this study. Demographic data and clinical information were obtained from medical chart review. Immunosenescence, or aging of the immune system was assessed by staining freshly-obtained peripheral blood with immunophenotyping panels and analyzing cells using multicolor flow cytometry. Result Consistent with previously observed in the general population, both T and monocyte immunosenescence in diabetic patients positively correlate with age. When compared to diabetic patients with preserved renal function (estimated glomerular filtration rate > 60 ml/min), patients with impaired renal function exhibit a significant decrease of total CD3+ and CD4+ T cells, but not CD8+ T cell and monocyte numbers. Immunosenescence was observed in patients with CKD stage 3 and in patients with more severe renal failure, especially of CD8+ T cells. However, immunosenescence was not associated with level of proteinuria level or glucose control. In age, sex and glucose level-adjusted regression models, stage 3 CKD patients exhibited significantly elevated percentages of CD28−, CD127−, and CD57+ cells among CD8+ T cells when compared to patients with preserved renal function. In contrast, no change was detected in monocyte subpopulations as renal function declined. In addition, higher body mass index (BMI) is associated with enhanced immunosenescence irrespective of CKD status. Conclusion The extent of immunosenescence is not significantly associated with proteinuria or glucose control in type 2 diabetic patients. T cells, especially the CD8+ subsets, exhibit aggravated characteristics of immunosenescence during renal function decline as early as stage 3 CKD. In addition, inflammation increases since stage 3 CKD and higher BMI drives the accumulation of CD8+CD57+ T cells. Our study indicates that therapeutic approaches such as weight loss may be used to prevent the emergence of immunosenescence in diabetes before stage 3 CKD.

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Effect of chronic kidney disease on outcomes following proximal humerus fragility fracture surgery in diabetic patients: A nationwide population-based cohort study

PLoS ONE ◽

10.1371/journal.pone.0258393 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258393

Author(s):

Chien-Tien Chen ◽

Su-Ju Lin ◽

Liang-Tseng Kuo ◽

Tien-Hsing Chen ◽

Wei-Hsiu Hsu ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Fragility Fracture ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Humerus Fracture ◽

Perioperative Outcomes ◽

Diabetic Patients ◽

Research Database

Background The proximal humerus fracture (PHF) is the third most common fragility fracture. Diabetes mellitus (DM) and chronic kidney disease (CKD) are both risks for fragility fractures; however, the interplay of DM and CKD makes treatment outcomes unpredictable. This study aimed to investigate and compare early and late outcomes following proximal humerus fracture fixation surgery in diabetic patients with different renal function conditions. Methods DM patients receiving PHF fixation surgery during 1998–2013 were recruited from Taiwan’s National Health Insurance Research Database. According to their renal function, patients were divided into three study groups: non-chronic kidney disease (CKD), non-dialysis CKD, and dialysis. Outcomes of interest were early and late perioperative outcomes. Early outcomes included in-hospital newly-onset morbidities. Late outcomes included infection, revision, readmission, and all-cause mortality. Results This study included a total of 10,850 diabetic patients: 2152 had CKD (non-dialysis CKD group), 196 underwent permanent dialysis (dialysis group), and the remaining 8502 did not have CKD (non-CKD group). During a mean follow-up of 5.56 years, the dialysis group showed the highest risk of overall infection, all-cause revision, readmission, and mortality compared to the non-dialysis CKD group and non-CKD group. Furthermore, subgroup analysis showed that CKD patients had a higher risk of surgical infection following PHF surgery than non-CKD patients in cases with a traffic accident or fewer comorbidities (Charlson Comorbidity Index, CCI <3) (P for interaction: 0.086 and 0.096, respectively). Also, CKD patients had an even higher mortality risk after PHF surgery than non-CKD patients, in females, those living in higher urbanization areas, or with more comorbidities (CCI ≥3) (P for interaction: 0.011, 0.057, and 0.069, respectively). Conclusion CKD was associated with elevated risks for infection, revision, readmission, and mortality after PHF fixation surgery in diabetic patients. These findings should be taken into consideration when caring for diabetic patients.

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