https://scholars.lib.ntu.edu.tw/handle/123456789/563291
Title: | Prognostic value of proteinuria and glomerular filtration rate on Taiwanese patients with diabetes mellitus and advanced chronic kidney disease: a single center experience | Authors: | PING-MIN CHEN Wada T. CHIH-KANG CHIANG |
Issue Date: | 2017 | Publisher: | Springer Tokyo | Journal Volume: | 21 | Journal Issue: | 2 | Start page/Pages: | 307-315 | Source: | Clinical and Experimental Nephrology | Abstract: | Background: Several risk factors were associated with poor outcomes in diabetic patients with chronic kidney disease (CKD). However, few studies addressed the prognostic implications of these factors in advanced CKD. Our study aimed to provide more evidence for risk factor stratification of diabetic patients with advanced CKD. Method: A total of 447 diabetic patients with advanced CKD, age of 18–80, who visited the nephrology out-patient clinic were enrolled. All patients were in stage 3B-5 CKD. The primary outcomes included long-term renal replacement therapy and mortality. The occurrence of cardiovascular events was also analyzed as secondary outcome. Multivariate Cox regression models were used to address each risk factor in this cohort. We also used this cohort to evaluate the validity of the modified diabetic nephropathy score. Results: Patients with lower estimated glomerular filtration rate (eGFR) were associated with higher degree of proteinuria. In the multivariate Cox regression model, eGFR and the degree of proteinuria were both strong outcome predictors. The effects of glycosylated hemoglobin and blood pressure in this advanced CKD cohort were minimal. Elder patients with advanced CKD had a higher mortality rate, but commenced less renal replacement therapy. Applying these indicator analyses, we proposed a modified diabetic nephropathy score for outcome prediction. Conclusions: Our analysis demonstrated the impact of eGFR and proteinuria in the advanced CKD group. Indicators in early CKD possessed a different prognostic profile in this advanced CKD cohort, therefore, necessitating a modified scoring system. ? 2016, Japanese Society of Nephrology. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84976277541&doi=10.1007%2fs10157-016-1290-8&partnerID=40&md5=f93d8e20020f8b433a1930ee934c622a https://scholars.lib.ntu.edu.tw/handle/123456789/563291 |
ISSN: | 1342-1751 | DOI: | 10.1007/s10157-016-1290-8 | SDG/Keyword: | angiotensin receptor antagonist; antihypertensive agent; antilipemic agent; dipeptidyl carboxypeptidase inhibitor; hemoglobin A1c; insulin; phosphate binding agent; adult; aged; Article; chronic kidney failure; diabetes mellitus; diabetic nephropathy; diabetic patient; diastolic blood pressure; disease severity; estimated glomerular filtration rate; female; hemoglobin blood level; human; major clinical study; male; mortality; mortality rate; outcome assessment; prognosis; proteinuria; renal replacement therapy; systolic blood pressure; Taiwanese; chi square distribution; Diabetic Nephropathies; disease course; glomerulus filtration rate; kidney; middle aged; multivariate analysis; pathophysiology; predictive value; proportional hazards model; proteinuria; Renal Insufficiency, Chronic; retrospective study; risk assessment; risk factor; Taiwan; time factor; Aged; Chi-Square Distribution; Diabetic Nephropathies; Disease Progression; Female; Glomerular Filtration Rate; Humans; Kidney; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Proteinuria; Renal Insufficiency, Chronic; Retrospective Studies; Risk Assessment; Risk Factors; Taiwan; Time Factors |
Appears in Collections: | 毒理學研究所 |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.