Tags

Type your tag names separated by a space and hit enter

Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.
Am J Kidney Dis. 2018 01; 71(1):112-122.AJ

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions.

STUDY DESIGN

Prospective cohort.

SETTING & PARTICIPANTS

Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks' gestation, and had kidney function measurements during 25 years of follow-up.

PREDICTOR

GDM was self-reported by women for each pregnancy.

OUTCOMES

CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25.

MEASUREMENTS

HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM.

RESULTS

During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83).

LIMITATIONS

Albuminuria was assessed by single untimed measurements of urine albumin and creatinine.

CONCLUSIONS

GDM is associated with the subsequent development of albuminuria among black women in CARDIA.

Authors+Show Affiliations

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: weavereg@med.unc.edu.Department of Biostatistics, University of Kansas School of Medicine, Kansas City, KS.Division of Research, Kaiser Permanente Northern California, Oakland, CA.Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.Department of Medicine, University of California San Francisco, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.Division of Nephrology and Hypertension, Department of Public Health Sciences and Medicine, Loyola Medical Center, Maywood, IL.UNC Kidney Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

29128412

Citation

Dehmer, Elizabeth W., et al. "Association Between Gestational Diabetes and Incident Maternal CKD: the Coronary Artery Risk Development in Young Adults (CARDIA) Study." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 71, no. 1, 2018, pp. 112-122.
Dehmer EW, Phadnis MA, Gunderson EP, et al. Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Kidney Dis. 2018;71(1):112-122.
Dehmer, E. W., Phadnis, M. A., Gunderson, E. P., Lewis, C. E., Bibbins-Domingo, K., Engel, S. M., Jonsson Funk, M., Kramer, H., Kshirsagar, A. V., & Heiss, G. (2018). Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 71(1), 112-122. https://doi.org/10.1053/j.ajkd.2017.08.015
Dehmer EW, et al. Association Between Gestational Diabetes and Incident Maternal CKD: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Kidney Dis. 2018;71(1):112-122. PubMed PMID: 29128412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study. AU - Dehmer,Elizabeth W, AU - Phadnis,Milind A, AU - Gunderson,Erica P, AU - Lewis,Cora E, AU - Bibbins-Domingo,Kirsten, AU - Engel,Stephanie M, AU - Jonsson Funk,Michele, AU - Kramer,Holly, AU - Kshirsagar,Abhijit V, AU - Heiss,Gerardo, Y1 - 2017/11/08/ PY - 2017/01/12/received PY - 2017/08/07/accepted PY - 2017/11/13/pubmed PY - 2019/6/30/medline PY - 2017/11/13/entrez KW - African American KW - CKD risk factor KW - Gestational diabetes mellitus (GDM) KW - albuminuria KW - chronic kidney disease (CKD) KW - diabetes mellitus KW - incident CKD KW - pregnancy KW - race/ethnicity SP - 112 EP - 122 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 71 IS - 1 N2 - BACKGROUND: Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions. STUDY DESIGN: Prospective cohort. SETTING & PARTICIPANTS: Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks' gestation, and had kidney function measurements during 25 years of follow-up. PREDICTOR: GDM was self-reported by women for each pregnancy. OUTCOMES: CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25. MEASUREMENTS: HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM. RESULTS: During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83). LIMITATIONS: Albuminuria was assessed by single untimed measurements of urine albumin and creatinine. CONCLUSIONS: GDM is associated with the subsequent development of albuminuria among black women in CARDIA. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/29128412/Association_Between_Gestational_Diabetes_and_Incident_Maternal_CKD:_The_Coronary_Artery_Risk_Development_in_Young_Adults__CARDIA__Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(17)30946-0 DB - PRIME DP - Unbound Medicine ER -