Association and risk factors of chronic kidney disease and incident diabetes: a nationwide population-based cohort study

Lin, Chung‐Sheng; Hsieh, Ming‐Chia; Kor, Chew‐Teng; Hsieh, Yih Shou

doi:10.1007/s00125-018-4788-7

Cited by 24 publications

(20 citation statements)

References 27 publications

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“…Moreover, there is a reverse causality that CKD is a risk factor of incident diabetes. 46 Recently, one study conducted MR analysis to determine the causal relationship between type 2 diabetes and decreased renal function in 11 502 Chinese population. 47 They reported that GRS associated with type 2 diabetes, insulin resistance, and insulin sensitivity had a significant relationship with decreased eGFR.…”

Section: Discussionmentioning

confidence: 99%

Impaired fasting glucose and development of chronic kidney disease in non-diabetic population: a Mendelian randomization study

Kim

Park

Kwon

et al. 2020

BMJ Open Diab Res Care

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IntroductionDiabetes mellitus is a risk factor of chronic kidney disease (CKD); however, the relationship between fasting glucose and CKD remains controversial in non-diabetic population. This study aimed to assess causal relationship between genetically predicted fasting glucose and incident CKD.Research design and methodsThis study included 5909 participants without diabetes and CKD from the Korean Genome Epidemiology Study. The genetic risk score (GRS9) was calculated using nine genetic variants associated with fasting glucose in previous genome-wide association studies. Incident CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and/or proteinuria (≥1+). The causal relationship between fasting glucose and CKD was evaluated using the Mendelian randomization (MR) approach.ResultsThe GRS9 was strongly associated with fasting glucose (β, 1.01; p<0.001). During a median follow-up of 11.6 years, 490 (8.3%) CKD events occurred. However, GRS9 was not significantly different between participants with CKD events and those without. After adjusting for confounding factors, fasting glucose was not associated with incident CKD (OR 0.990; 95% CI 0.977 to 1.002; p=0.098). In the MR analysis, GRS9 was not associated with CKD development (OR per 1 SD increase, 1.179; 95% CI 0.819 to 1.696; p=0.376). Further evaluation using various other MR methods and strict CKD criteria (decrease in the eGFR of ≥30% to a value of <60 mL/min/1.73 m2) found no significant relationship between GRS9 and incident CKD.ConclusionsFasting glucose was not causally associated with CKD development in non-diabetic population.

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Section: Discussionmentioning

confidence: 99%

Impaired fasting glucose and development of chronic kidney disease in non-diabetic population: a Mendelian randomization study

Kim

Park

Kwon

et al. 2020

BMJ Open Diab Res Care

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“…One of the reasons for this discrepancy might be explained by the differences in the method of survival analysis. A competing risk might have been prevalent in the CKD population 16 , 17 . In this regard, progression to ERSD and pre‐ESRD death compete with each other, because pre‐ESRD death completely hinders any observation of the progression to ESRD, as does the ESRD progression to pre‐ESRD death 17 .…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, progression to ERSD and pre‐ESRD death compete with each other, because pre‐ESRD death completely hinders any observation of the progression to ESRD, as does the ESRD progression to pre‐ESRD death 17 . Conventional survival analyses, including the Kaplan–Meier method and Cox proportional hazards model that were used previously, treated competing events as non‐informational censored data, presumably causing an overestimation of the cumulative incidence of the primary event of interest 16 , 17 . To overcome these issues, we used a competing risk model to evaluate the effect of depression severity on progression to ESRD and pre‐ESRD death.…”

Section: Discussionmentioning

confidence: 99%

Effect of depression on progression to end‐stage renal disease or pre‐end‐stage renal disease death in advanced diabetic nephropathy: A prospective cohort study of the Diabetes Study from the Center of Tokyo Women’s Medical University

Horiba

Ishizawa

Takasaki

et al. 2021

J of Diabetes Invest

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Aims/Introduction: This study aimed to determine the effect of depression on the progression to end-stage renal disease (ESRD) and pre-ESRD death in patients with advanced diabetic nephropathy. Materials and Methods: This single-center prospective cohort study enrolled Japanese patients with type 2 diabetes and advanced diabetic nephropathy. The total Patient Health Questionnaire-9 score was used to evaluate depression at baseline and classified patients into: no, mild and severe depression groups. The outcomes were ESRD, defined as initiation of renal replacement therapy, and pre-ESRD death. The relationship between the severity of depression and these outcomes was analyzed using a competing risks model, defining each outcome as the competing risk of the other outcome. Results: Of the 486 patients with a mean estimated glomerular filtration rate of 37.1 -21.1 mL/min/1.73 m 2 , 345 were men. During the median follow up of 4.4 years, 164 patients progressed to ESRD and 50 died. The cumulative incidence function of ESRD was significantly higher in the severe depression group (Gray's test, P = 0.003). The ESRD risk increased by 12.4% and 45.1% in patients with mild and severe depression, respectively, compared with those without depression, although these differences did not reach statistical significance in the multivariate subdistribution hazard model (P = 0.450 and 0.161, respectively). The cumulative incidence of death was similar for the study groups. Conclusion: Depression potentially has a weak impact on progression to ESRD, however, the presence of comorbidities might have the possibility to reduce the effect of depression on the renal outcome in patients with advanced diabetic nephropathy.

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“…Another population-based cohort study in Taiwan found that CKD was a significant and independent predictor of incident diabetes(adjusted HR 1.204; 95% CI 1.11, 1.31) [19].…”

Section: Discussionmentioning

confidence: 99%

Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

Guan

Chen

et al. 2020

Preprint

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Background: Previous studies have revealed that chronic kidney disease (CKD) is one of major risk factors of insulin resistance and diabetes. However, there are few investigations of the correlations between the estimated glomerular filtration rate (eGFR) and incident diabetes, especially in Chinese population. This study was taken to explore the relationship between eGFR and incident diabetes in a large cohort in Chinese community population. Methods: The present study was a retrospective cohort study. A total of 199,435 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were eGFR measured at baseline and incident diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association between eGFR and incident diabetes. Generalized additive model was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website. Result: After adjusting gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, smoking and drinking status and family history of diabetes, result showed eGFR was negatively associated with incident diabetes (HR=0.987, 95%CI (0.984, 0.989)). A J shape relationship was detected between eGFR and incident diabetes, which had an inflection point of eGFR was 97.967 mL/min-1·(1.73 m2)-1. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 0.999 (0.994,1.004) and 0.977 (0.974,0.981), respectively. Subgroup analysis showed, the stronger association can be found in the population with FPG<6.1mmol/L, BMI<24kg/m2, SBP<140mmHg, DBP<90mmHg, HDL in middle level and family history without diabetes. The same trend was also seen in men and in the population with never or ever smoking. Conclusion: eGFR is independently associated with incident diabetes. The relationship between eGFR and incident diabetes is also non-linear. eGFR was strong negatively related to incident diabetes when eGFR is above 97.967 mL/min-1·(1.73 m2)-1.

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Association and risk factors of chronic kidney disease and incident diabetes: a nationwide population-based cohort study

Cited by 24 publications

References 27 publications

Impaired fasting glucose and development of chronic kidney disease in non-diabetic population: a Mendelian randomization study

Impaired fasting glucose and development of chronic kidney disease in non-diabetic population: a Mendelian randomization study

Effect of depression on progression to end‐stage renal disease or pre‐end‐stage renal disease death in advanced diabetic nephropathy: A prospective cohort study of the Diabetes Study from the Center of Tokyo Women’s Medical University

Association of evaluated glomerular filtration rate and incident diabetes mellitus: a secondary retrospective analysis based on a Chinese Cohort Study

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