Risk of chronic kidney disease in patients with a hyperglycemic crisis as the initial presentation of type 2 diabetes.
Humans
Diabetes Mellitus, Type 2
/ complications
Female
Male
Renal Insufficiency, Chronic
/ epidemiology
Middle Aged
Taiwan
/ epidemiology
Adult
Risk Factors
Hyperglycemia
/ complications
Aged
Incidence
Diabetic Nephropathies
/ epidemiology
Diabetic Ketoacidosis
/ epidemiology
Proportional Hazards Models
Chronic kidney disease
Diabetic ketoacidosis
Diabetic kidney disease
Hyperglycemic crisis
Hyperglycemic hyperosmolar state
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
20 Jul 2024
20 Jul 2024
Historique:
received:
15
03
2024
accepted:
15
07
2024
medline:
21
7
2024
pubmed:
21
7
2024
entrez:
20
7
2024
Statut:
epublish
Résumé
Limited data exist on long-term renal outcomes in patients with hyperglycemic crisis (HC) as initial type 2 diabetes presentation. We evaluated the risk of chronic kidney disease (CKD) development in those with concurrent HC at diagnosis. Utilizing Taiwan's insurance claims from adults newly diagnosed with type 2 diabetes during 2006-2015, we created HC and matched non-HC cohorts. We assessed incident CKD/diabetic kidney disease (DKD) by 2018's end, calculating the hazard ratio (HR) with the Cox model. Each cohort comprised 13,242 patients. The combined CKD and DKD incidence was two-fold higher in the HC cohort than in the non-HC cohort (56.47 versus 28.49 per 1000 person-years) with an adjusted HR (aHR) of 2.00 (95% confidence interval [CI] 1.91-2.10]). Risk increased from diabetic ketoacidosis (DKA) (aHR:1.69 [95% CI 1.59-1.79]) to hyperglycemic hyperosmolar state (HHS) (aHR:2.47 [95% CI 2.33-2.63]) and further to combined DKA-HHS (aHR:2.60 [95% CI 2.29-2.95]). Subgroup analysis in individuals aged ≥ 40 years revealed a similar trend with slightly reduced incidences and HRs. Patients with HC as their initial type 2 diabetes presentation face a higher CKD risk than do those without HC. Enhanced medical attention and customized interventions are crucial to reduce this risk.
Identifiants
pubmed: 39033190
doi: 10.1038/s41598-024-67678-3
pii: 10.1038/s41598-024-67678-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
16746Subventions
Organisme : Ministry of Health and Welfare
ID : MOHW110-TDU-B-212-124004
Organisme : Ministry of Science and Technology, Taiwan
ID : MOST 110-2321-B-039-003
Organisme : China Medical University Hospital
ID : DMR-111-228
Organisme : China Medical University Hospital
ID : CMU110-MF-63
Informations de copyright
© 2024. The Author(s).
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