Diabetes with early kidney involvement may shorten life expectancy by 16 years
Journal
Kidney International
Journal Volume
92
Journal Issue
2
Pages
388-396
Date Issued
2017
Author(s)
Abstract
This study aimed to identify the excess risks associated with diabetic patients with early kidney involvement (early diabetic kidney disease). The mortality risks of early diabetic kidney disease, defined as diabetes in early stages 1-3 chronic kidney disease (CKD), were assessed from a cohort of 512,700 adults in Taiwan participating in a health surveillance program from 1994-2008. Three related groups were identified and compared: diabetes without CKD, early diabetic kidney disease, and early CKD without diabetes. Deaths were ascertained through the National Death Registry. One-third of diabetics had early kidney disease, and approximately two-thirds of patients were classified with early CKD due to proteinuria. Patients with early diabetic kidney disease had more lifestyle risks such as inactivity or obesity, which characteristically amplified excess mortality by up to five times. The three-fold increase in all-cause mortality (hazard ratio 3.16) and a 16-year loss in life expectancy made early diabetic kidney disease a serious and yet often overlooked disease, with most patients unaware of their kidney involvement. Mortality for early diabetic kidney disease was nearly twice as high as that for early CKD (hazard ratio 2.01) or diabetes without CKD (hazard ratio 1.79). The 16-year life span loss is much worse than individually from early CKD (six years) or diabetes (ten years). Thus, identifying early proteinuria among diabetic patients and realizing the importance of reducing lifestyle risks like inactivity is a clinical challenge, but can save lives. ? 2017 International Society of Nephrology
SDGs
Other Subjects
adult; Article; chronic kidney failure; cohort analysis; diabetes mellitus; diabetic nephropathy; disease association; disease classification; disease course; disease registry; disease surveillance; female; high risk patient; human; life expectancy; lifespan; major clinical study; male; mortality risk; obesity; physical inactivity; priority journal; proteinuria; risk assessment; risk reduction; sedentary lifestyle; Taiwan; blood pressure; diabetic nephropathy; epidemiology; glomerulus filtration rate; glucose blood level; life expectancy; lifestyle; middle aged; mortality; prospective study; risk factor; Adult; Blood Glucose; Blood Pressure; Diabetic Nephropathies; Female; Glomerular Filtration Rate; Humans; Life Expectancy; Life Style; Male; Middle Aged; Prospective Studies; Renal Insufficiency, Chronic; Risk Factors; Taiwan
Publisher
Elsevier B.V.
Type
journal article