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Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus.
Kidney Int. 2015 Apr; 87(4):784-91.KI

Abstract

This observational study examined the association between modifiable lifestyle and social factors on the incidence and progression of early chronic kidney disease (CKD) among those with type 2 diabetes. All 6972 people from the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) with diabetes but without macroalbuminuria were studied. CKD progression was defined as decline in GFR of more than 5% per year, progression to end-stage renal disease, microalbuminuria, or macroalbuminuria at 5.5 years. Lifestyle/social factors included tobacco and alcohol use, physical activity, stress, financial worries, the size of the social network and education. Adjustments were made for known risks such as age, diabetes duration, GFR, albuminuria, gender, body mass index, blood pressure, fasting plasma glucose, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers use. Competing risk of death was considered. At study end, 31% developed CKD and 15% had died. The social network score (SNS) was a significant independent risk factor of CKD and death, reducing the risk by 11 and 22% when comparing the third to the first tertile of the SNS (odds ratios of CKD 0.89 and death 0.78). Education showed a significant association with CKD but stress and financial worries did not. Those with moderate alcohol consumption had a significantly decreased CKD risk compared with nonusers. Regular physical activity significantly decreased the risk of CKD. Thus, lifestyle is a determinant of kidney health in people at high cardiovascular risk with diabetes.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Dunkler D
1] Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada [2] University of Erlangen-Nürnberg, Department of Nephrology, Erlangen, Germany [3] Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Kohl M
1] Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada [2] University of Erlangen-Nürnberg, Department of Nephrology, Erlangen, Germany [3] Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Heinze G
Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
Teo KK
Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada.
Rosengren A
Sahlgrenska University Hospital/Östra Hospital, Göteborg, Sweden.
Pogue J
Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada.
Gao P
Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada.
Gerstein H
Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada.
Yusuf S
Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada.
Oberbauer R
1] Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria [2] KH Elisabethinen Linz and Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Mann JF
1] Population Health Research Institute, Hamilton Health Sciences/McMaster University, Hamilton, ON, Canada [2] University of Erlangen-Nürnberg, Department of Nephrology, Erlangen, Germany [3] Schwabing General Hospital, and KfH Kidney Center, Munich, Germany.
ONTARGET Investigators
No affiliation info available

MeSH

AgedAlbuminuriaAlcohol DrinkingAnxietyDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionEducational StatusFemaleGlomerular Filtration RateHumansLife StyleMaleMiddle AgedMotor ActivityRenal Insufficiency, ChronicRisk FactorsSmokingSocial SupportStress, Psychological

Pub Type(s)

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

Language

eng

PubMed ID

25493953

Citation

Dunkler, Daniela, et al. "Modifiable Lifestyle and Social Factors Affect Chronic Kidney Disease in High-risk Individuals With Type 2 Diabetes Mellitus." Kidney International, vol. 87, no. 4, 2015, pp. 784-91.
Dunkler D, Kohl M, Heinze G, et al. Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus. Kidney Int. 2015;87(4):784-91.
Dunkler, D., Kohl, M., Heinze, G., Teo, K. K., Rosengren, A., Pogue, J., Gao, P., Gerstein, H., Yusuf, S., Oberbauer, R., & Mann, J. F. (2015). Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus. Kidney International, 87(4), 784-91. https://doi.org/10.1038/ki.2014.370
Dunkler D, et al. Modifiable Lifestyle and Social Factors Affect Chronic Kidney Disease in High-risk Individuals With Type 2 Diabetes Mellitus. Kidney Int. 2015;87(4):784-91. PubMed PMID: 25493953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus. AU - Dunkler,Daniela, AU - Kohl,Maria, AU - Heinze,Georg, AU - Teo,Koon K, AU - Rosengren,Annika, AU - Pogue,Janice, AU - Gao,Peggy, AU - Gerstein,Hertzel, AU - Yusuf,Salim, AU - Oberbauer,Rainer, AU - Mann,Johannes F E, AU - ,, Y1 - 2014/12/10/ PY - 2014/06/09/received PY - 2014/09/09/revised PY - 2014/09/11/accepted PY - 2014/12/11/entrez PY - 2014/12/11/pubmed PY - 2016/2/18/medline SP - 784 EP - 91 JF - Kidney international JO - Kidney Int VL - 87 IS - 4 N2 - This observational study examined the association between modifiable lifestyle and social factors on the incidence and progression of early chronic kidney disease (CKD) among those with type 2 diabetes. All 6972 people from the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) with diabetes but without macroalbuminuria were studied. CKD progression was defined as decline in GFR of more than 5% per year, progression to end-stage renal disease, microalbuminuria, or macroalbuminuria at 5.5 years. Lifestyle/social factors included tobacco and alcohol use, physical activity, stress, financial worries, the size of the social network and education. Adjustments were made for known risks such as age, diabetes duration, GFR, albuminuria, gender, body mass index, blood pressure, fasting plasma glucose, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers use. Competing risk of death was considered. At study end, 31% developed CKD and 15% had died. The social network score (SNS) was a significant independent risk factor of CKD and death, reducing the risk by 11 and 22% when comparing the third to the first tertile of the SNS (odds ratios of CKD 0.89 and death 0.78). Education showed a significant association with CKD but stress and financial worries did not. Those with moderate alcohol consumption had a significantly decreased CKD risk compared with nonusers. Regular physical activity significantly decreased the risk of CKD. Thus, lifestyle is a determinant of kidney health in people at high cardiovascular risk with diabetes. SN - 1523-1755 UR - https://www.unboundmedicine.com/medline/citation/25493953/Modifiable_lifestyle_and_social_factors_affect_chronic_kidney_disease_in_high_risk_individuals_with_type_2_diabetes_mellitus_ DB - PRIME DP - Unbound Medicine ER -