Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease

详细信息    查看全文

• 作者：Miguel Á ; ngel Salinero-Fort^a ; ^b ; ^c ; ^{miguel.salinero@salud.madrid.org" class="auth_mail" title="E-mail the corresponding author} ; Francisco Javier San Andr&eacute ; s-Rebollo^d ; Carmen de Burgos-Lunar^b ; ^c ; ^e ; Juan Carlos Abá ; nades-Herranz^a ; ^b ; Enrique Carrillo-de-Santa-Pau^f ; Rosa Marí ; a Chico-Moraleja^g ; Rodrigo Jim&eacute ; nez-Garcí ; a^h ; Ana Ló ; pez-de-Andr&eacute ; s^h ; Paloma Gó ; mez-Campelo^b ; ⁱ ; On behalf of MADIABETES Group
• 关键词：Diabetes mellitus ; type 2 ; Diabetes complications ; Kidney diseases ; Mortality ; Cohort studies
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：30
• 期：2
• 页码：227-236
• 全文大小：373 K

文摘

To assess the prevalence of stage 3–5 chronic kidney disease (CKD) at baseline and to identify associated risk factors. To determine the effect of CKD and CKD stage according to estimated glomerular filtration rate (eGFR) and albuminuria categories on all-cause and cardiovascular mortality after a 5-year follow-up.

Methods

Prospective cohort study of 3443 outpatients with type 2 diabetes mellitus.

Results

The prevalence of CKD was 28.32% (95% CI, 26.84–29.86); and variables most strongly associated were: age > 74 years (OR, 19.88; 95% CI, 12.89–30.68) and albuminuria (OR, 2.27; 95% CI, 1.72–3.00).

During follow-up, 221 CKD patients (22.90%) died compared with 203 non-CKD patients (8.31%) (p < 0.01).

The adjusted HR of CKD for cardiovascular and all-cause mortality was 1.82 (95% CI, 1.36–2.44) and 2.11 (95% CI, 1.61–2.76) for those with LDL cholesterol = 135 mg/dl, respectively. The adjusted HR of very-high-risk CKD for all-cause mortality was 4.44 (95% CI, 2.31–8.53) in aged < 75 years and 1.80 (95% CI, 1.19–2.72) in aged ≥ 75 years.

Conclusions

CKD at baseline is an independent risk factor for all-cause and cardiovascular mortality in the overall cohort, men and women, or in primary and secondary prevention of coronary heart disease. Albuminuria is an independent risk factor for all-cause and cardiovascular mortality only in primary prevention.