In a nutshell
This study investigated factors that may lead to the development of chronic kidney disease (CKD) in patients with type 1 diabetes (T1D).
Some background
CKD is a serious complication of T1D. CKD is detected in two ways. One is a reduction in eGFR (estimated glomerular filtration rate; a measure of kidney function). The other is the presence of a protein called albumin in the urine (albuminuria). Increased albumin in the urine is often the first sign of kidney damage. Knowing what factors can predict the onset of CKD could be of benefit.
Methods & findings
2656 adults with T1D were examined for 5 years. At the start of the study all participants had normal kidney function. They were monitored once a year. At this time HbA1c levels (measures average blood glucose over the last 3 months), blood pressure, cholesterol, triglycerides (fat in the blood), and medication use were examined. Any patients who developed CKD (albuminuria, and/or reduced eGFR) were noted.
Over the 5 years 21% of participants developed CKD. 18% developed albuminuria and 4.3% developed reduced eGFR. 1.2% developed both albuminuria and reduced eGFR.
Participants who had had T1D for a longer time, and those who had high triglycerides were more likely to develop albuminuria. The risk of albuminuria increased 16% for every 1% increase in HbA1c. Those who were being treated with drugs to lower blood pressure were more than twice as likely to develop albuminuria than those who were not. Those who had proliferative retinopathy (disease affecting blood vessels in the eye) were 57% more likely to develop albuminuria than those who did not. Smokers were 84% more likely to develop albuminuria than non-smokers.
Increased age increased the risk of developing reduced eGFR. Those who had a lower eGFR at the start of the study were also more likely to have a reduced eGFR at the end.
The bottom line
The study concluded that age, duration of diabetes, high triglycerides, high HbA1c levels, high blood pressure, other complications of diabetes, smoking, and low eGFR are associated with the development of CKD.
The fine print
The participants in this study were examined in different centers, which may make comparisons difficult. Furthermore, the follow-up period was relatively short.
What’s next?
Discuss the risk of developing complications of diabetes with your physician.
Published By :
Scientific reports
Date :
Jun 12, 2017
