Abysmal prognosis of patients with type 2 diabetes entering dialysis

Chantrel, F.; Enache, Ioana; Bouiller, M.; Kolb, I; Kunz, Kristian; Petitjean, Philippe; Moulin, B.; Hannedouche, T

doi:10.1093/ndt/14.1.129

Cited by 105 publications

(47 citation statements)

References 3 publications

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“…After 211 days, 32% of diabetic patients were deceased secondary to CVD. In this study the authors also determined that early referral of patients to nephrologists could improve prognosis (20). Our findings were also consistent with this study.…”

Section: Dıscussıonsupporting

confidence: 91%

A Retrospective Analysis of Five Year Data of End-Stage Renal Disease Patients: A Single Center Experience

Türkmen¹,

Tunç²,

Solak³

et al. 2011

Turk Neph Dial Transpl

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OBJECTıvES: CKD is a worldwide threat to public health. Approximately 1.8 million people are currently being treated with renal replacement therapy including hemodialysis, peritoneal dialysis and transplantation. The etiology and factors affecting the progression of chronic kidney disease to endstage renal disease (ESRD) differ in industrialized and underdeveloped countries. STudY dESıGn:The aim of the study was to investigate the etiologies of ESRD, factors affecting progression to ESRD and mortality rates of patients between 2000-2004, in Konya, a city in the Middle Anatolian region of Turkey. maTERıal and mETHOdS:We included 417 end-stage renal disease patients (207 female and 210 male) between 16-90 years old receiving RRT for the first time in the study. CKD was diagnosed by GFR measurement that was calculated by MDRD formula. Co-morbidity was expressed using WrightKhan index. RESulTS:We showed that there was an increased rate of diabetic nephropathy between 2003 and 2004. The increased rate of diabetic nephropathy was found to be statistically significant in the last two years (p<0.005). There was also significant negative correlation between mortality and diastolic BP (r: -0.143, p: 0.05) and the education level of the patients (r: -0.159, p: 0.0002). There was a positive correlation between mortality and serum urea levels (r: 0.193, p: 0.0001), HD through a catheter for the first time (r: 0.140, p: 0.0006), and receiving HD by a continuous RRT modality (r: 0.163, p: 0.0001).COnCluSıOn: Our study showed that advanced age, increased mean arterial BP before the first RRT, having CVD or DM as an etiology of ESRD, increased erythrocyte sedimentation rate (ESR), decreased serum albumin levels and the presence of co-morbid diseases were the main factors that affected survival of the patients. BulGulaR: Çalışmamızda, 2003-2004 yılları arasında diyabetik nefropati sıklığında artış saptandı (p<0,005). Mortalite ile hastaların diyastolik kan basıncı ve eğitim durumu arasında istatistiksel olarak anlamlı negatif korelasyon saptanırken, serum üre düzeyi, HD'e kateter yoluyla girmek ve RRT olarak HD'e devam edilmesi arasında anlamlı olarak pozitif korelasyon bulundu.SOnuÇ: Çalışmamızda, ileri yaş, ilk RRT öncesinde yüksek ortalama kan basıncı varlığı, kardiyovasküler hastalık mevcudiyeti, SDBY nedeni olarak diyabetin saptanması, artmış ESH, serum albumin düzeyinin düşüklüğü ve ko-morbid hastalıkların varlığı ile hastaların yaşam süreleri arasında ilişki tespit edildi.anaHTaR SözCÜKlER: Son dönem böbrek yetmezliği, Renal replasman tedavisi, Diyabet

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Section: Dıscussıonsupporting

confidence: 91%

A Retrospective Analysis of Five Year Data of End-Stage Renal Disease Patients: A Single Center Experience

Türkmen¹,

Tunç²,

Solak³

et al. 2011

Turk Neph Dial Transpl

View full text Add to dashboard Cite

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“…The reason that we were not able to show an association between ESRF and Pro12Ala in our patients with type 2 diabetes might be related to the fact that ESRF is a more complex phenotype that is determined by a plethora of different pathophysiological as well as genetic factors. However, patients with type 2 diabetes have an excessive cardiovascular risk, leading to a dramatically reduced survival before ESRF develops (6,19), therefore introducing a bias toward low ESRF rates that hampers the unraveling of the underlying genetic risk factors. In the development of diabetic nephropathy, morphologic changes such as thickening of the glomerular basement membrane, glomerular hypertrophy, mesangial expansion, and modest expansion of the tubulointerstitium play a role.…”

Section: Discussionmentioning

confidence: 99%

Peroxisome Proliferator-Activated Receptor-γ2 Polymorphism Pro12Ala Is Associated With Nephropathy in Type 2 Diabetes

et al. 2002

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The Pro12Ala polymorphism of the gene encoding the peroxisome proliferator-activated receptor (PPAR)-␥2 has recently been shown to be associated with type 2 diabetes. In the present analysis, we investigated whether PPAR-␥2 Pro12Ala was associated with microvascular complications of type 2 diabetes, such as albuminuria, end-stage renal failure (ESRF), or retinopathy. A total of 445 patients with type 2 diabetes who were enrolled in the Berlin Diabetes Mellitus Study and in whom we determined albuminuria and the presence of ESRF and retinopathy were genotyped for the PPAR-␥2 Pro12Ala polymorphism. We also measured potentially important covariables, such as blood pressure, BMI, duration of diabetes, glycosylated hemoglobin, serum creatinine, and serum lipids. Among 445 patients with type 2 diabetes (mean age 59.3 years), the Pro12Ala genotype distribution was in Hardy-Weinberg equilibrium (P ‫؍‬ 0.42). The Ala12 allele frequency was 0.14. With adjustment for covariables, the 118 Ala12 allele carriers had significantly lower urinary albumin excretion (UAE) than the 327 noncarriers (17.1 vs. 25.8 mg/d; P ‫؍‬ 0.01). The percentage decrease in UAE observed in PPAR-␥ Ala12 allele carriers relative to noncarriers (P ‫؍‬ 0.003) rose from 0.2% (P ‫؍‬ 0.99) to 54% (P ‫؍‬ 0.008) and to 70% (P ‫؍‬ 0.01) when the duration of diabetes increased from <10 years to 10 -19 years and to >20 years, respectively. Similarly, the odds ratios of having albuminuria decreased from 1.22 (P ‫؍‬ 0.54) to 0.61 (P ‫؍‬ 0.23) and to 0.11 (P ‫؍‬ 0.007), respectively. Among patients with type 2 diabetes, PPAR-␥2 Ala12 allele carriers had significantly lower UAE and tended to develop overt proteinuria less frequently. These observations suggest a protective effect of the Ala12 allele in relation to diabetic nephropathy. Diabetes 51: 2653-2657, 2002

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“…Aunque al comparar la prevalencia de factores de riesgo entre diabéticos y no diabéticos solo se observaron diferencias importantes en cuanto al ITB e IMC alterados, varios estudios han demostrado el mayor riesgo de complicaciones cardiovasculares en los pacientes diabéticos y los beneficios de la intervención integral [22][23][24] , en este sentido, adicional al control metabólico, acciones como la medición del para los pacientes y eficiencias para el sistema de salud. Estudios posteriores evaluarán el modelo en términos de desenlaces clínicos, costos y calidad de vida de los pacientes.…”

Section: Tablaunclassified

Description of a disease management model in patients undergoing dialysis in Colombia

Bunch¹,

Tamer²,

Ardila³

et al. 2016

acnef

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Abysmal prognosis of patients with type 2 diabetes entering dialysis

Cited by 105 publications

References 3 publications

A Retrospective Analysis of Five Year Data of End-Stage Renal Disease Patients: A Single Center Experience

A Retrospective Analysis of Five Year Data of End-Stage Renal Disease Patients: A Single Center Experience

Peroxisome Proliferator-Activated Receptor-γ2 Polymorphism Pro12Ala Is Associated With Nephropathy in Type 2 Diabetes

Description of a disease management model in patients undergoing dialysis in Colombia

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