The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes.
The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes.
复制标题
DOI：
10.2337/db08-1543
复制
发表时间：
2009-07
期刊：
影响因子：
7.7
通讯作者：
FinnDiane Study Group
中科院分区：
文献类型：
--
作者：
Groop PH;Thomas MC;Moran JL;Wadèn J;Thorn LM;Mäkinen VP;Rosengård-Bärlund M;Saraheimo M;Hietala K;Heikkilä O;Forsblom C;FinnDiane Study Group
本研究的目的是确定与1型糖尿病成人大的当代队列中过早死亡相关的临床特征。芬兰糖尿病肾病（FinnDiane）研究是一项全国性多中心前瞻性随访研究，共有4，201名1型糖尿病成年人参加，他们来自芬兰的21所大学和中心医院，33所地区医院和26所初级卫生保健中心。在中位7年的随访期间，有291例死亡（7%），比年龄和性别匹配的一般人群中观察到的死亡多3.6倍（95%CI 3.2-4.0）。仅在慢性肾脏疾病患者中观察到死亡率过高。正常白蛋白尿患者的死亡率没有超过一般人群（标准化死亡率比[SMR] 0.8，95%CI 0.5-1.1），与糖尿病病程无关。微量白蛋白尿、大量白蛋白尿和终末期肾病的存在分别与SMR高2.8、9.2和18.3倍相关。每一阶段白蛋白尿的死亡率增加与先前存在的大血管疾病所带来的风险相当。此外，肾小球滤过率与死亡率独立相关，因此肾功能受损的个体以及表现出超滤过的个体的死亡风险增加。在一个大型的1型糖尿病个体当代队列中，观察到肾脏疾病的存在和严重程度与死亡率之间存在独立的分级相关性。这些发现强调了慢性肾脏疾病及其在1型糖尿病管理中的预防的临床和公共卫生重要性。
This study aimed to identify clinical features associated with premature mortality in a large contemporary cohort of adults with type 1 diabetes. The Finnish Diabetic Nephropathy (FinnDiane) study is a national multicenter prospective follow-up study of 4,201 adults with type 1 diabetes from 21 university and central hospitals, 33 district hospitals, and 26 primary health care centers across Finland. During a median 7 years of follow-up, there were 291 deaths (7%), 3.6-fold (95% CI 3.2–4.0) more than that observed in the age- and sex-matched general population. Excess mortality was only observed in individuals with chronic kidney disease. Individuals with normoalbuminuria showed no excess mortality beyond the general population (standardized mortality ratio [SMR] 0.8, 95% CI 0.5–1.1), independent of the duration of diabetes. The presence of microalbuminuria, macroalbuminuria, and end-stage kidney disease was associated with 2.8, 9.2, and 18.3 times higher SMR, respectively. The increase in mortality across each stage of albuminuria was equivalent to the risk conferred by preexisting macrovascular disease. In addition, the glomerular filtration rate was independently associated with mortality, such that individuals with impaired kidney function, as well as those demonstrating hyperfiltration, had an increased risk of death. An independent graded association was observed between the presence and severity of kidney disease and mortality in a large contemporary cohort of individuals with type 1 diabetes. These findings highlight the clinical and public health importance of chronic kidney disease and its prevention in the management of type 1 diabetes.
登录
查看更多内容
影响因子：
8.2
作者：
Bruno, G.;Merletti, F.;Cavallo-Perin, P.
通讯作者：
Cavallo-Perin, P.
影响因子：
19.6
作者：
Astrup, AS;Tarnow, L;Parving, HH
通讯作者：
Parving, HH
影响因子：
16.2
作者：
Astrup, AS;Tarnow, U;Parving, HH
通讯作者：
Parving, HH
影响因子：
19.6
作者：
Amin, R;Turner, C;Dunger, DB
通讯作者：
Dunger, DB
影响因子：
16.2
作者：
Asao, K;Sarti, C;Tajima, N
通讯作者：
Tajima, N