Academic Journal
The relationship between estimated glomerular filtration rate trajectory and all-cause mortality in type 2 diabetes: the Fremantle Diabetes Study
| العنوان: | The relationship between estimated glomerular filtration rate trajectory and all-cause mortality in type 2 diabetes: the Fremantle Diabetes Study |
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| المؤلفون: | Davis, Timothy M E, Chubb, S A Paul, Davis, Wendy A |
| المصدر: | European Journal of Endocrinology ; volume 175, issue 4, page 273-285 ; ISSN 0804-4643 1479-683X |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2016 |
| الوصف: | Objective To investigate the association between estimated GFR (eGFR) and all-cause mortality, including the contribution of temporal eGFR changes, in well-characterised community-based patients with type 2 diabetes. Design Longitudinal observational study. Methods Participants from the Fremantle Diabetes Study Phase 1 were assessed between 1993 and 1996 and followed until end-December 2012. Cox proportional hazards modelling was used to assess the relationship between baseline eGFR category (Stage 1–5) and all-cause death, and between eGFR trajectories assigned by semiparametric group-based modelling (GBM) and all-cause death in patients with five post-baseline annual eGFR measurements. Results In the full cohort (1296 patients; mean± s.d. age 64.1±11.3years, 48.6% males), 738 (56.9%) died during 12.9±6.1years of follow-up. There was a U-shaped relationship between all-cause death and eGFR category. With Stage 3 (45–59mL/min/1.73m 2 ) as reference, the strongest association was for eGFR ≥90mL/min/1.73m 2 (hazard ratio (95% CI) 2.01 (1.52–2.66); P <0.001). GBM identified four linear trajectories (‘low’, ‘medium’, ‘high’, ‘high/declining’) in 532 patients with serial eGFR measurements. With medium trajectory as reference, eGFR trajectory displaced baseline eGFR category as an independent predictor of death, with low and high/declining trajectories associated with more than double the risk (2.03 (1.30–3.18) and 2.24 (1.31–3.83) respectively, P ≤0.003) and associated median reductions in survival of 6.5 and 8.7years respectively. Conclusion There is a nonlinear relationship between eGFR and death in type 2 diabetes, which is at least partially explained by a sub-group of patients with an initially high but then rapidly declining eGFR. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| DOI: | 10.1530/eje-16-0327 |
| الاتاحة: | http://dx.doi.org/10.1530/eje-16-0327 https://eje.bioscientifica.com/view/journals/eje/175/4/273.xml |
| رقم الانضمام: | edsbas.522BC808 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1530/eje-16-0327 |
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