Tags

Type your tag names separated by a space and hit enter

All-cause and cardiovascular mortality in diabetic subjects increases significantly with reduced estimated glomerular filtration rate (eGFR): 10 years' data from the South Tees Diabetes Mortality study.
Diabet Med. 2007 Jan; 24(1):10-7.DM

Abstract

AIMS

To investigate the association between estimated glomerular filtration rate (eGFR) and total and cardiovascular mortality in a population-based cohort of diabetic subjects.

METHODS

A longitudinal study using a population-based district diabetes register comprising 3288 subjects in South Tees, UK. The eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) study equation. Patients were stratified by baseline eGFR into five stages as per the National Kidney Foundation guidelines: Stage 1, eGFR > 90; Stage 2, eGFR 60-89; Stage 3, eGFR 30-59; Stage 4, eGFR 15-29; and Stage 5, eGFR < 15 ml/min per 1.73 m(2). Main outcome was all-cause and cardiovascular mortality between 1 January 1994 and 31 July 2004.

RESULTS

At baseline, mean age (58.4 years) differed between groups. Persons with lower eGFR were older (P < 0.001). Thirty-six percent (n = 1193, males 56%) had died by 10 years (cardiovascular cause in 60%). Median follow-up was 10.5 years amounting to 28 342 person years. Stages 4 and 5 (eGFR <or= 29 ml/min per 1.73 m(2)) were amalgamated for mortality analysis. Total and cardiovascular mortality increased with reduced eGFR. Adjusted hazard ratios (HR) [95% confidence interval (CI)] for all-cause mortality comparing groups 2 and 3, and 4 and 5 combined with group 1 were 1.28 (1.02, 1.60), 2.58 (2.05, 3.25) and 6.42 (4.25, 9.71), respectively. Adjusted HRs (95% CI) for mortality due to circulatory disease comparing groups 2 and 3, and 4 and 5 combined with group 1 were 1.50 (1.10, 2.06), 3.32 (2.41, 4.58) and 7.99 (4.69, 13.62), respectively.

CONCLUSIONS

In diabetic subjects, mortality increases significantly with reduced GFR. Low eGFR identifies patients at high risk of cardiovascular mortality who should be targeted for aggressive risk factor modification.

Authors+Show Affiliations

James Cook University Hospital, Middlesbrough, UK. sath.nag@stees.nhs.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17227319

Citation

Nag, S, et al. "All-cause and Cardiovascular Mortality in Diabetic Subjects Increases Significantly With Reduced Estimated Glomerular Filtration Rate (eGFR): 10 Years' Data From the South Tees Diabetes Mortality Study." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 24, no. 1, 2007, pp. 10-7.
Nag S, Bilous R, Kelly W, et al. All-cause and cardiovascular mortality in diabetic subjects increases significantly with reduced estimated glomerular filtration rate (eGFR): 10 years' data from the South Tees Diabetes Mortality study. Diabet Med. 2007;24(1):10-7.
Nag, S., Bilous, R., Kelly, W., Jones, S., Roper, N., & Connolly, V. (2007). All-cause and cardiovascular mortality in diabetic subjects increases significantly with reduced estimated glomerular filtration rate (eGFR): 10 years' data from the South Tees Diabetes Mortality study. Diabetic Medicine : a Journal of the British Diabetic Association, 24(1), 10-7.
Nag S, et al. All-cause and Cardiovascular Mortality in Diabetic Subjects Increases Significantly With Reduced Estimated Glomerular Filtration Rate (eGFR): 10 Years' Data From the South Tees Diabetes Mortality Study. Diabet Med. 2007;24(1):10-7. PubMed PMID: 17227319.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - All-cause and cardiovascular mortality in diabetic subjects increases significantly with reduced estimated glomerular filtration rate (eGFR): 10 years' data from the South Tees Diabetes Mortality study. AU - Nag,S, AU - Bilous,R, AU - Kelly,W, AU - Jones,S, AU - Roper,N, AU - Connolly,V, PY - 2007/1/18/pubmed PY - 2007/6/30/medline PY - 2007/1/18/entrez SP - 10 EP - 7 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 24 IS - 1 N2 - AIMS: To investigate the association between estimated glomerular filtration rate (eGFR) and total and cardiovascular mortality in a population-based cohort of diabetic subjects. METHODS: A longitudinal study using a population-based district diabetes register comprising 3288 subjects in South Tees, UK. The eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) study equation. Patients were stratified by baseline eGFR into five stages as per the National Kidney Foundation guidelines: Stage 1, eGFR > 90; Stage 2, eGFR 60-89; Stage 3, eGFR 30-59; Stage 4, eGFR 15-29; and Stage 5, eGFR < 15 ml/min per 1.73 m(2). Main outcome was all-cause and cardiovascular mortality between 1 January 1994 and 31 July 2004. RESULTS: At baseline, mean age (58.4 years) differed between groups. Persons with lower eGFR were older (P < 0.001). Thirty-six percent (n = 1193, males 56%) had died by 10 years (cardiovascular cause in 60%). Median follow-up was 10.5 years amounting to 28 342 person years. Stages 4 and 5 (eGFR <or= 29 ml/min per 1.73 m(2)) were amalgamated for mortality analysis. Total and cardiovascular mortality increased with reduced eGFR. Adjusted hazard ratios (HR) [95% confidence interval (CI)] for all-cause mortality comparing groups 2 and 3, and 4 and 5 combined with group 1 were 1.28 (1.02, 1.60), 2.58 (2.05, 3.25) and 6.42 (4.25, 9.71), respectively. Adjusted HRs (95% CI) for mortality due to circulatory disease comparing groups 2 and 3, and 4 and 5 combined with group 1 were 1.50 (1.10, 2.06), 3.32 (2.41, 4.58) and 7.99 (4.69, 13.62), respectively. CONCLUSIONS: In diabetic subjects, mortality increases significantly with reduced GFR. Low eGFR identifies patients at high risk of cardiovascular mortality who should be targeted for aggressive risk factor modification. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/17227319/All_cause_and_cardiovascular_mortality_in_diabetic_subjects_increases_significantly_with_reduced_estimated_glomerular_filtration_rate__eGFR_:_10_years'_data_from_the_South_Tees_Diabetes_Mortality_study_ L2 - https://doi.org/10.1111/j.1464-5491.2007.02023.x DB - PRIME DP - Unbound Medicine ER -