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Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease.
J Diabetes Complications. 2016 Mar; 30(2):227-36.JD

Abstract

AIMS

To assess the prevalence of stage 3-5 chronic kidney disease (CKD) at baseline and to identify associated risk factors. To determine the effect of CKD and CKD stage according to estimated glomerular filtration rate (eGFR) and albuminuria categories on all-cause and cardiovascular mortality after a 5-year follow-up.

METHODS

Prospective cohort study of 3443 outpatients with type 2 diabetes mellitus.

RESULTS

The prevalence of CKD was 28.32% (95% CI, 26.84-29.86); and variables most strongly associated were: age >74 years (OR, 19.88; 95% CI, 12.89-30.68) and albuminuria (OR, 2.27; 95% CI, 1.72-3.00). During follow-up, 221 CKD patients (22.90%) died compared with 203 non-CKD patients (8.31%) (p<0.01). The adjusted HR of CKD for cardiovascular and all-cause mortality was 1.82 (95% CI, 1.36-2.44) and 2.11 (95% CI, 1.61-2.76) for those with LDL cholesterol =135 mg/dl, respectively. The adjusted HR of very-high-risk CKD for all-cause mortality was 4.44 (95% CI, 2.31-8.53) in aged <75 years and 1.80 (95% CI, 1.19-2.72) in aged ≥75 years.

CONCLUSIONS

CKD at baseline is an independent risk factor for all-cause and cardiovascular mortality in the overall cohort, men and women, or in primary and secondary prevention of coronary heart disease. Albuminuria is an independent risk factor for all-cause and cardiovascular mortality only in primary prevention.

Authors+Show Affiliations

Gerencia Adjunta de Planificación y Calidad, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain. Electronic address: miguel.salinero@salud.madrid.org.Centro de Salud Las Calesas, Servicio Madrileño de Salud, Madrid, Spain.Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain; Servicio de Medicina Preventiva, Hospital Universitario La Paz, Servicio Madrileño de Salud, Madrid, Spain.Gerencia Adjunta de Planificación y Calidad, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain.Centro Nacional de Investigaciones Oncológicas, Madrid, Spain.Hospital Central de la Defensa, Madrid, Spain.Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Plataforma de Apoyo al Investigador Novel-PAIN Platform, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

26627635

Citation

Salinero-Fort, Miguel Ángel, et al. "Cardiovascular and All-cause Mortality in Patients With Type 2 Diabetes Mellitus in the MADIABETES Cohort Study: Association With Chronic Kidney Disease." Journal of Diabetes and Its Complications, vol. 30, no. 2, 2016, pp. 227-36.
Salinero-Fort MÁ, San Andrés-Rebollo FJ, de Burgos-Lunar C, et al. Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease. J Diabetes Complications. 2016;30(2):227-36.
Salinero-Fort, M. Á., San Andrés-Rebollo, F. J., de Burgos-Lunar, C., Abánades-Herranz, J. C., Carrillo-de-Santa-Pau, E., Chico-Moraleja, R. M., Jiménez-García, R., López-de-Andrés, A., & Gómez-Campelo, P. (2016). Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease. Journal of Diabetes and Its Complications, 30(2), 227-36. https://doi.org/10.1016/j.jdiacomp.2015.10.007
Salinero-Fort MÁ, et al. Cardiovascular and All-cause Mortality in Patients With Type 2 Diabetes Mellitus in the MADIABETES Cohort Study: Association With Chronic Kidney Disease. J Diabetes Complications. 2016;30(2):227-36. PubMed PMID: 26627635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease. AU - Salinero-Fort,Miguel Ángel, AU - San Andrés-Rebollo,Francisco Javier, AU - de Burgos-Lunar,Carmen, AU - Abánades-Herranz,Juan Carlos, AU - Carrillo-de-Santa-Pau,Enrique, AU - Chico-Moraleja,Rosa María, AU - Jiménez-García,Rodrigo, AU - López-de-Andrés,Ana, AU - Gómez-Campelo,Paloma, AU - ,, Y1 - 2015/10/21/ PY - 2015/07/07/received PY - 2015/09/30/revised PY - 2015/10/14/accepted PY - 2015/12/3/entrez PY - 2015/12/3/pubmed PY - 2016/12/15/medline KW - Cohort studies KW - Diabetes complications KW - Diabetes mellitus, type 2 KW - Kidney diseases KW - Mortality SP - 227 EP - 36 JF - Journal of diabetes and its complications JO - J Diabetes Complications VL - 30 IS - 2 N2 - AIMS: To assess the prevalence of stage 3-5 chronic kidney disease (CKD) at baseline and to identify associated risk factors. To determine the effect of CKD and CKD stage according to estimated glomerular filtration rate (eGFR) and albuminuria categories on all-cause and cardiovascular mortality after a 5-year follow-up. METHODS: Prospective cohort study of 3443 outpatients with type 2 diabetes mellitus. RESULTS: The prevalence of CKD was 28.32% (95% CI, 26.84-29.86); and variables most strongly associated were: age >74 years (OR, 19.88; 95% CI, 12.89-30.68) and albuminuria (OR, 2.27; 95% CI, 1.72-3.00). During follow-up, 221 CKD patients (22.90%) died compared with 203 non-CKD patients (8.31%) (p<0.01). The adjusted HR of CKD for cardiovascular and all-cause mortality was 1.82 (95% CI, 1.36-2.44) and 2.11 (95% CI, 1.61-2.76) for those with LDL cholesterol =135 mg/dl, respectively. The adjusted HR of very-high-risk CKD for all-cause mortality was 4.44 (95% CI, 2.31-8.53) in aged <75 years and 1.80 (95% CI, 1.19-2.72) in aged ≥75 years. CONCLUSIONS: CKD at baseline is an independent risk factor for all-cause and cardiovascular mortality in the overall cohort, men and women, or in primary and secondary prevention of coronary heart disease. Albuminuria is an independent risk factor for all-cause and cardiovascular mortality only in primary prevention. SN - 1873-460X UR - https://www.unboundmedicine.com/medline/citation/26627635/Cardiovascular_and_all_cause_mortality_in_patients_with_type_2_diabetes_mellitus_in_the_MADIABETES_Cohort_Study:_Association_with_chronic_kidney_disease_ DB - PRIME DP - Unbound Medicine ER -