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Clinical outcomes in patients with type 2 diabetes mellitus-related kidney disease: A Jordanian population cohort study.
Farah, Randa; Alhajahjeh, Abdulrahman; Nofal, Amani; Hyasat, Tala Basheer; Abu Jabeh, Raghed Abdel Hay; Suboh, Lojayn Tareq; Alhawari, Hussam; Momani, Munther S; Jaber, Hazem Jamal; AlAwwa, Izzat.
Affiliation
  • Farah R; Nephrology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan. Electronic address: r.farah@ju.edu.jo.
  • Alhajahjeh A; School of Medicine, University of Jordan, Amman, Jordan.
  • Nofal A; School of Medicine, University of Jordan, Amman, Jordan.
  • Hyasat TB; School of Medicine, University of Jordan, Amman, Jordan.
  • Abu Jabeh RAH; School of Medicine, University of Jordan, Amman, Jordan.
  • Suboh LT; School of Medicine, University of Jordan, Amman, Jordan.
  • Alhawari H; Endocrinology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan.
  • Momani MS; Endocrinology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan.
  • Jaber HJ; Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan.
  • AlAwwa I; Nephrology Division, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan.
J Diabetes Complications ; 37(6): 108478, 2023 06.
Article in En | MEDLINE | ID: mdl-37084653
BACKGROUND: Diabetic kidney disease (DKD) increases the risk of cardiovascular (CV) complications, kidney disease progression, and mortality. We aimed to determine the incidence and risk of these outcomes according to DKD phenotype among the Jordanian population. METHODS: A total of 1172 type 2 diabetes mellitus patients with estimated glomerular filtration rates (eGFRs) of >30 ml/min/1.73 m2 were followed-up from 2019 to 2022. At baseline, patients were classified according to the presence of albuminuria (>30 mg/g creatinine) and reduced eGFR (<60 ml/min/1.73 m2) into four phenotypes: non-DKD (reference category), albuminuric DKD without decreased eGFR, non-albuminuric DKD with decreased eGFR, and albuminuric DKD with decreased eGFR. RESULTS: Mean follow-up was 2.9 ± 0.4 years. Overall, 147 patients (12.5 %) experienced CV events, while 61 (5.2 %) demonstrated kidney disease progression (eGFR: <30 ml/min/1.73 m2). The mortality rate was 4.0 %. Multivariable-adjusted risk for CV events and mortality was greatest for the albuminuric DKD with decreased eGFR group (hazard ratio [HR]: 1.45, 95 % confidence interval [CI]: 1.02-2.33 and HR: 6.36, 95 % CI: 2.98-13.59, respectively), with the risk increasing when adjusted for prior CV history (HR: 1.47, 95 % CI: 1.06-3.42 and HR: 6.70, 95 % CI: 2.70-16.60, respectively). Risk of a ≥40 % decline in eGFR was greatest for the albuminuric DKD with decreased eGFR group (HR: 3.45, 95 % CI: 1.74-6.85), followed by the albuminuric DKD without decreased eGFR group (HR: 1.6, 95 % CI: 1.06-2.75). CONCLUSION: Thus, patients with albuminuric DKD and decreased eGFR were at greater risk for poor CV, renal, and mortality outcomes compared to other phenotypes.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Diabetic Nephropathies Type of study: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limits: Humans Country/Region as subject: Asia Language: En Journal: J Diabetes Complications Journal subject: ENDOCRINOLOGIA Year: 2023 Document type: Article Country of publication: Estados Unidos

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Diabetic Nephropathies Type of study: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limits: Humans Country/Region as subject: Asia Language: En Journal: J Diabetes Complications Journal subject: ENDOCRINOLOGIA Year: 2023 Document type: Article Country of publication: Estados Unidos