Renal function and attributable risk of death and cardiovascular hospitalization in participants with diabetes from a registry-based cohort |
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| Authors: | Manuel Ruiz-Quintero Josep Redón María Téllez-Plaza Ana M. Cebrián-Cuenca Jorge Navarro-Pérez Edelmiro Menéndez Ana Perez-Navarro Antonio Fernández-Giménez Adriana López-Pineda José A. Quesada Vicente Pallares-Carratalá Vicente F. Gil-Guillen José M. Martin-Moreno Jesús Bleda-Cano Sara Carrascosa Concepción Carratalá-Munuera |
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| Affiliation: | 1. Agost Primary Health Care Center, Agost 03698, Alicante, Spain;2. Department of Internal Medicine, Hospital Clinico de Valencia, University of Valencia, INCLIVA Research Institute, Valencia 46010, Spain;3. CIBERObn, ISCIII, Madrid, Spain;4. Institute for Biomedical Research. Hospital Clinic of Valencia, Valencia, Spain;5. San Anton Primary Health Center, Cartagena, 30205 Murcia, Spain;6. Valencia Clinic Hospital, Department of Medicine, University of Valencia, INCLIVA Research Institute, Valencia 46010, Spain;7. Endocrinology and Nutrition Department, Central de Asturias University Hospital, ENDO Group, Health Research Institut of Principado de Asturias (ISPA), Oviedo 33011, Spain;8. ESCARVAL Group Study CRO, CEO of Exilio SI SL, Valencia 46010, Spain;9. Health Surveillance Department, Union de Mutuas, 12004 Castellon, Spain;10. Medicine Department, Jaume I University, 12071, Castellon, Spain;11. Department of Preventive Medicine & INCLIVA, University of Valencia, Valencia 46010, Spain;12. Centro de salud integrado El Campello, El Campello 03560, Alicante, Spain;13. Consultorio Auxiliar Garbinet de Alicante, Alicante 03015, Spain;14. Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Alicante, Spain |
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| Abstract: | AimsTo estimate the attributable risk of renal function on all-cause mortality and cardiovascular hospitalization in patients with diabetes.MethodsA prospective cohort study in 19,469 adults with diabetes, free of cardiovascular disease, attending primary care in Spain (2008–2011). The estimated glomerular filtration rate (eGFR) and other variables were collected and patients were followed to the first hospitalization for coronary or stroke event, or death, until the end of 2012. The cumulative incidence of the study endpoints by eGFR categories was graphically displayed and adjusted population attributable risks (PARs) for low eGFR was calculated.ResultsMean follow-up was 3.2 years and 506 deaths and 1720 hospitalizations were recorded. The cumulative risk for the individual events increased as eGFR levels decreased. The PAR associated with having an eGFR of 60 mL/min/1.73 m2 or less was 11.4% (95% CI 4.8–18.3) for all-cause mortality, 9.2% (95% CI 5.3–13.4) for coronary heart disease, and 2.6% (95% CI ?1.8 to 7.4) for stroke.ConclusionsReduced eGFR levels were associated with a larger proportion of avoidable deaths and cardiovascular hospitalizations in people with diabetes compared to previously reported results in people with other cardiovascular risk factors. |
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| Keywords: | Kidney dysfunction Hypertension Diabetes mellitus Attributable risk Mortality Cardiovascular diseases CKD" },{" #name" :" keyword" ," $" :{" id" :" kw0040" }," $$" :[{" #name" :" text" ," _" :" chronic kidney disease GFR" },{" #name" :" keyword" ," $" :{" id" :" kw0050" }," $$" :[{" #name" :" text" ," _" :" glomerular filtration rate ACR" },{" #name" :" keyword" ," $" :{" id" :" kw0060" }," $$" :[{" #name" :" text" ," _" :" albumin-to-creatinine ratio CVD" },{" #name" :" keyword" ," $" :{" id" :" kw0070" }," $$" :[{" #name" :" text" ," _" :" cardiovascular disease CVR" },{" #name" :" keyword" ," $" :{" id" :" kw0080" }," $$" :[{" #name" :" text" ," _" :" cardiovascular risk CV" },{" #name" :" keyword" ," $" :{" id" :" kw0090" }," $$" :[{" #name" :" text" ," _" :" cardiovascular DM" },{" #name" :" keyword" ," $" :{" id" :" kw0100" }," $$" :[{" #name" :" text" ," _" :" diabetes mellitus eGFR" },{" #name" :" keyword" ," $" :{" id" :" kw0110" }," $$" :[{" #name" :" text" ," _" :" estimated glomerular filtration rate K/DOQI" },{" #name" :" keyword" ," $" :{" id" :" kw0120" }," $$" :[{" #name" :" text" ," _" :" Kidney Disease Outcome Quality Initiative NHANES" },{" #name" :" keyword" ," $" :{" id" :" kw0130" }," $$" :[{" #name" :" text" ," _" :" National Health and Nutrition Examination Survey BMI" },{" #name" :" keyword" ," $" :{" id" :" kw0140" }," $$" :[{" #name" :" text" ," _" :" body mass index HER" },{" #name" :" keyword" ," $" :{" id" :" kw0150" }," $$" :[{" #name" :" text" ," _" :" electronic health record CKD-EPI" },{" #name" :" keyword" ," $" :{" id" :" kw0160" }," $$" :[{" #name" :" text" ," _" :" chronic kidney disease epidemiology collaboration STROBE" },{" #name" :" keyword" ," $" :{" id" :" kw0170" }," $$" :[{" #name" :" text" ," _" :" strengthening the reporting of observational studies in epidemiology HDL" },{" #name" :" keyword" ," $" :{" id" :" kw0180" }," $$" :[{" #name" :" text" ," _" :" high density-lipoprotein LDL" },{" #name" :" keyword" ," $" :{" id" :" kw0190" }," $$" :[{" #name" :" text" ," _" :" low-density lipoprotein IDMS" },{" #name" :" keyword" ," $" :{" id" :" kw0200" }," $$" :[{" #name" :" text" ," _" :" isotope dilution mass spectrometry CHD" },{" #name" :" keyword" ," $" :{" id" :" kw0210" }," $$" :[{" #name" :" text" ," _" :" coronary heart disease ICD" },{" #name" :" keyword" ," $" :{" id" :" kw0220" }," $$" :[{" #name" :" text" ," _" :" International Classification of Diseases CIOMS" },{" #name" :" keyword" ," $" :{" id" :" kw0230" }," $$" :[{" #name" :" text" ," _" :" Council for International Organizations of Medical Sciences DGSP-CSISP" },{" #name" :" keyword" ," $" :{" id" :" kw0240" }," $$" :[{" #name" :" text" ," _" :" Committee for Ethics and Clinical Trials of the Center for Public Health Research PARs" },{" #name" :" keyword" ," $" :{" id" :" kw0250" }," $$" :[{" #name" :" text" ," _" :" population attributable risks CI" },{" #name" :" keyword" ," $" :{" id" :" kw0260" }," $$" :[{" #name" :" text" ," _" :" confidence interval RR" },{" #name" :" keyword" ," $" :{" id" :" kw0270" }," $$" :[{" #name" :" text" ," _" :" related relative risks |
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