Response to Comment on Niewczas et al. Circulating Modified Metabolites and a Risk of ESRD in Patients With Type 1 Diabetes and Chronic Kidney Disease. Diabetes Care 2017;40:383–390

ObjectiveWe examined changes in prevalence of diabetic microvascular/macrovascular complications and diabetes care indicators for adults in Japan with type 2 and type 1 diabetes over one decade.Research design and methodsTwo independent cohorts were recruited with the same inclusion criteria in 2004 (cohort 1: 3319 with type 2 and 286 with type 1 diabetes) and in 2014 (cohort 2: 3932 with type 2 and 308 with type 1 diabetes). Prevalence of complications and care indicators including achieving treatment targets for glycemia, blood pressure, lipid control, body mass index (BMI), and smoking were compared. In addition, patients in cohort 1 were re-examined in 2014 and their data were compared with the baseline data of each cohort.ResultsIn type 2 diabetes, the prevalence of nephropathy, retinopathy, neuropathy, chronic kidney disease, current smoking and stroke significantly decreased, with improvements in achieving treatment target rates in cohort 2 two as compared with cohort 1. In type 1 diabetes, the prevalence of nephropathy, retinopathy, chronic kidney disease, and hemoglobin A1Cvalues significantly decreased. Decreases in prevalence of microvascular complications in type 2 diabetes were similarly found in each age-matched and sex-matched group, whereas younger patients exhibited marked increase in BMI and lower treatment target achieving rates compared with elderly patients. Regarding normoalbuminuric renal impairment, only a slight increase in the prevalence was observed both in type 2 and type 1 diabetes. In cohort 1, re-examined in 2014, care indicators were significantly improved from 2004, while complications increased with getting 10 years older.ConclusionsWe observed declining trends of diabetic microvascular complications with improvement in diabetes care indicators in type 2 and type 1 diabetes. Younger patients with type 2 diabetes exhibited marked increase in BMI and lower rates of achieving treatment targets compared with elderly patients, which remains a concern.

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Features of thyroid state in patients with type 1 diabetes and chronic kidney disease receiving renal replacement therapy

Endocrine Abstracts ◽

10.1530/endoabs.70.ep455 ◽

2020 ◽

Author(s):

Alena Sazonava ◽

Tatiana Mokhort ◽

Natalia Karlovich

Keyword(s):

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Renal Replacement Therapy ◽

Kidney Disease ◽

Replacement Therapy ◽

Thyroid State

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1621-P: Period Prevalence of Chronic Kidney Disease and Obesity in Adults with Type 1 Diabetes

Diabetes ◽

10.2337/db20-1621-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1621-P

Author(s):

AMELIA WALLACE ◽

ALEX R. CHANG ◽

MORGAN GRAMS ◽

ELIZABETH SELVIN

Keyword(s):

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Kidney Disease ◽

Period Prevalence

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Faculty Opinions recommendation of In patients with type 1 diabetes and new-onset microalbuminuria the development of advanced chronic kidney disease may not require progression to proteinuria.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1362957.834055 ◽

2009 ◽

Author(s):

Matthew Breyer

Keyword(s):

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Kidney Disease ◽

Advanced Chronic Kidney Disease ◽

New Onset

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Faculty Opinions recommendation of In patients with type 1 diabetes and new-onset microalbuminuria the development of advanced chronic kidney disease may not require progression to proteinuria.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1362957.5433064 ◽

2010 ◽

Author(s):

Takahiko Nakagawa

Keyword(s):

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Kidney Disease ◽

Advanced Chronic Kidney Disease ◽

New Onset

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455-P: Global Comparisons of Awareness of Chronic Kidney Disease and Renoprotective Therapies among Type 1 Diabetes Patients

Diabetes ◽

10.2337/db21-455-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 455-P

Author(s):

EMILY YE ◽

JULIA STEVENSON ◽

JACQUELINE TAIT ◽

REBECCA GOWEN ◽

SARA SUHL ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Kidney Disease ◽

Diabetes Patients

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Early Glomerular Filtration Rate Loss as a Marker of Diabetic Nephropathy

US Endocrinology ◽

10.17925/use.2012.08.01.40 ◽

2012 ◽

Vol 08 (01) ◽

pp. 40 ◽

Cited By ~ 2

Author(s):

George Jerums ◽

Elif Ekinci ◽

Sianna Panagiotopoulos ◽

Richard J MacIsaac ◽

◽

...

Keyword(s):

Chronic Kidney Disease ◽

Type 1 Diabetes ◽

Diabetic Nephropathy ◽

Glomerular Filtration Rate ◽

Kidney Disease ◽

Glomerular Filtration ◽

Filtration Rate ◽

Clinical Level ◽

Ckd Stage

In the early 1980s, studies in type 1 diabetes suggested that glomerular filtration rate (GFR) loss begins with the onset of macroalbuminuria. However, recent evidence indicates that up to one-quarter of subjects with diabetes reach a GFR of less than 60 ml/min/1.73 m2(chronic kidney disease [CKD] stage 3) before developing micro- or macroalbuminuria. Furthermore, the prospective loss of GFR can be detected in early diabetic nephropathy (DN) well before CKD stage 3. Early GFR loss usually reflects DN in type 1 diabetes but, in older patients with type 2 diabetes, the assessment of early GFR loss needs to take into account the effects of aging. The assessment of GFR is now feasible at clinical level, using formulas based on serum creatinine, age, gender, and ethnicity. Overall, the estimation of early GFR loss is more accurate with the Chronic Kidney Disease Epidemiology (CKD–EPI) formula than with the Modification of Diet in Renal Disease (MDRD) study formula, but there is some evidence that the CKD-EPI formula does not exhibit better performance than the MDRD formula for estimating GFR in diabetes. Both formulas underestimate GFR in the hyperfiltration range. Formulas based on the reciprocal of cystatin C can also be used to estimate GFR, but their cost and lack of assay standardization have delayed their use at clinical level. In summary, early GFR loss is an important marker of DN as well as a potentially reversible target for interventions in DN.

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