Age modifies the risk factor profiles for acute kidney injury among recently diagnosed type 2 diabetic patients: a population-based study
Journal
GeroScience
Journal Volume
40
Journal Issue
2
Pages
201-217
Date Issued
2018
Author(s)
Abstract
The incidence of acute kidney injury (AKI) rises with age and is associated with multiple risk factors. Here, we compared the risk factors for AKI between younger and older incident diabetic patients to examine the trends in risk alteration for individual factors across different age groups. Between 2007 and 2013, we selected all incident type 2 diabetic adults from the Taiwan National Health Insurance registry, stratified based on age: young (< 65?years), old (? 65 but < 75?years), and older-old (? 75?years). All factors with potential renal influence (e.g., comorbidities, medications, and diagnostics/procedures) were recorded during the study period, with a nested case-controlled approach utilized to identify independent risk factors for AKI in each age group. Totally, 930,709 type 2 diabetic patients were categorized as young (68.7%), old (17.7%), or older-old (13.6%). Older-old patients showed a significantly higher incidence of AKI than the old and the young groups. Cardiovascular morbidities (hypertension, atrial fibrillation, acute coronary syndrome, and cerebrovascular disease) were shown to increase the risk of AKI, although the risk declined with increasing age. Chronic obstructive pulmonary disease and receiving cardiac catheterization elevated the risk of AKI preferentially?in the older-old/old and older-old group, respectively, while the administration of angiotensin-converting enzyme/α-blocker and angiotensin receptor blocker/calcium channel blocker reduced the risk of AKI preferentially?in the older-old and older-old/old group, respectively. In conclusion, our findings highlight the importance of devising age-specific risk factor panels for AKI in patients with recently diagnosed type 2 diabetes. ? 2018, American Aging Association.
SDGs
Other Subjects
alpha adrenergic receptor blocking agent; angiotensin receptor antagonist; calcium channel blocking agent; dipeptidyl carboxypeptidase; acute coronary syndrome; acute kidney failure; adult; age; aged; Article; atrial fibrillation; case control study; cerebrovascular disease; chronic obstructive lung disease; comorbidity; controlled study; diabetic patient; diagnostic procedure; drug use; female; heart catheterization; human; hypertension; incidence; major clinical study; male; non insulin dependent diabetes mellitus; risk factor; risk reduction; Taiwan; trend study; acute kidney failure; age; aging; cohort analysis; comparative study; geriatric assessment; middle aged; multivariate analysis; non insulin dependent diabetes mellitus; physiology; prognosis; propensity score; register; retrospective study; risk assessment; severity of illness index; statistical model; Acute Kidney Injury; Adult; Age Factors; Aged; Aging; Cohort Studies; Comorbidity; Diabetes Mellitus, Type 2; Female; Geriatric Assessment; Humans; Incidence; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prognosis; Propensity Score; Registries; Retrospective Studies; Risk Assessment; Severity of Illness Index; Taiwan
Publisher
Springer International Publishing
Type
journal article