Association Between Estimated Glomerular Filtration Rate and Microvascular Complications in Type II Diabetes Mellitus Patients: A 1-Year Cross-Sectional Study

Babaliche, Prakash; Nadpara, Rishit A.; Maldar, Arif

doi:10.1016/j.jnma.2018.06.003

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…Previously ESRD mortality might have been attributed to hypertension but more recently might have been attributed to diabetic nephropathy. [21,29] Therefore, the reported increase in diabetic nephropathy related mortality might be affected by a change in understanding of diabetic nephropathy. Of note, intensive glycemic control has been widely studied for its benefits in renal outcomes [30].…”

Section: Increased Mortality In Diabetic Nephropathymentioning

confidence: 99%

Global trend of diabetes mortality attributed to vascular complications, 2000–2016

Wei

Huang

et al. 2020

Cardiovasc Diabetol

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Background The global epidemic of diabetes mellitus continues to grow and affects developed and developing countries alike. Intensive glycemic control is thought to modify the risks for vascular complications, hence the risks for diabetes-related death. We investigated the trend of diabetic vascular complication-related deaths between 2000 and 2016 in the global diabetes landscape. Methods We collected 17 years of death certificates data from 108 countries in the World Health Organization mortality database between 2000 and 2016, with coding for diabetic complications. Crude and age-standardized proportions and rates were calculated. Trend analysis was done with annual average percentage change (AAPC) of rates computed by joinpoint regression. Results From 2000 through 2016, 7,108,145 deaths of diabetes were reported in the 108 countries. Among them, 26.8% (1,904,787 cases) were attributed to vascular complications in damaged organs, including the kidneys (1,355,085 cases, 71.1%), peripheral circulatory (515,293 cases, 27.1%), nerves (28,697 cases, 1.5%) and eyes (5751 cases, 0.3%). Overall, the age-standardized proportion of vascular complication-related mortality was 267.8 [95% confidence interval (95% CI), 267.5–268.1] cases per 1000 deaths and the rate was 53.6 (95% CI 53.5–53.7) cases per 100,000 person-years. Throughout the 17-year period, the overall age-standardized proportions of deaths attributable to vascular complications had increased 37.9%, while the overall age-standardized mortality rates related to vascular complications had increased 30.8% (AAPC = 1.9% [1.4–2.4%, p < 0.05]). These increases were predominantly driven by a 159.8% increase in the rate (AAPC = 2.7% [1.2–4.3%, p < 0.05]) from renal complications. Trends in the rates and AAPC of deaths varied by type of diabetes and of complications, as well as by countries, regions and domestic income. Conclusion Diabetic vascular complication-related deaths had increased substantially during 2000–2016, mainly driven by the increased mortality of renal complications.

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Section: Increased Mortality In Diabetic Nephropathymentioning

confidence: 99%

Global trend of diabetes mortality attributed to vascular complications, 2000–2016

Wei

Huang

et al. 2020

Cardiovasc Diabetol

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“…Nephropathy was assessed using estimated glomerular filtration rate (eGFR) which was calculated by the abbreviated MDRD equation (Modification of Diet in Renal Disease). 18 Based on the patient's history, physical examination and laboratory findings, vascular complications of diabetes were diagnosed by an endocrinologist (SM).…”

Section: Data Collection and Quality Control Measuresmentioning

confidence: 99%

Prevalence of Vascular Complications Among Type 2 Diabetic Patients in a Rural Health Center in South India

Venguidesvarane

Jasmine

Varadarajan

et al. 2020

J Prim Care Community Health

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Introduction: Vascular complications are the major cause of morbidity in patients with diabetes mellitus. Screening for these complications is crucial in early detection and tertiary prevention. Hence, this study aimed at finding the prevalence of micro and macrovascular complications and their associated factors in type 2 diabetes mellitus patients in a rural health center by using simple and easily available tools. Methodology: This hospital based cross sectional study was conducted in Rural Health and Training Centre (RHTC) of Sri Ramachandra medical college from Jan 2017 to Aug 2017. All type 2 diabetes patients registered at RHTC were included in the study. By the use of questionnaire, clinical examination and laboratory investigations, the prevalence of macro and microvascular complications and associated factors were ascertained. Multiple logistic regression was used to identify factors associated with vascular complications of diabetes. Results: The study included 390 type 2 diabetes patients. The overall prevalence of macrovascular and microvascular complications in our study population was 29.7% and 52.1%, respectively. Among the macrovascular complications, both coronary artery disease (CAD) and peripheral vascular disease (PVD) had a prevalence rate of 15.1%. Among the microvascular complications, peripheral neuropathy (44.9%) had the highest prevalence followed by nephropathy (12.1%) and diabetic foot (7.2%). Multiple logistic regression analyses showed high HbA1c level, lower education, high postprandial blood sugar, hypertension, abdominal obesity were significantly associated with increased risk of vascular complications of diabetes. Conclusion: This study demonstrated the increased prevalence of vascular complications in Type 2 diabetes patients in rural India. Regular screening to identify those patients at risk could prevent further progression of complications.

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“…Assessment of eGFR is the best method to study the overall renal function. Serum creatinine is the most utilized indirect endogenous filtration indicator of determining eGFR (17).…”

Section: Estimated Glomerular Filtration Ratementioning

confidence: 99%

Vascular endothelial growth factor expression in diabetic nephropathy; a clinico-pathological study

2020

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Introduction: Diabetes is an illness of epidemic magnitude, and the figures are rising each year. Diabetic nephropathy (DN) is a dreaded long-term complication of diabetes and the most common reason for end-stage renal disease (ESRD). Microalbuminuria is considered as a non-invasive indicator of early onset of DN. Renal biopsy is vital to know the extent of renal damage. Vascular endothelial growth factor (VEGF) plays a key role in angiogenesis and has been implicated in the pathogenesis and development of the disease. Objectives: To assess the expression of VEGF in different classes of DN and to evaluate its association with the known clinical and histopathological prognostic factors. Patients and Methods: Fifty-five patients of DN undergoing a renal biopsy were studied and classified according to the "pathologic classification of DN" by Tervaert et al. Glomerular and tubular staining of VEGF was recorded. P values of less than 0.05 were considered statistically significant. Results: Of 55 patients, eight patients belonged to class II, 24 to class III, and 23 to class IV. VEGF was positive in six (75%) of class II, 17 (70.83%) of class III and eight (34.7%) of class IV biopsies. A statistically significant correlation between classes of DN with estimated glomerular filtration rate (eGFR), serum creatinine, serum urea, diabetic retinopathy, hematuria, VEGF positivity and staining intensity was observed. Conclusion: A precise assessment of renal damage in DN can be conducted by studying renal biopsies. VEGF expression is increased in the early stage of diabetes however; further studies could open up new avenues for early diagnosis and management.

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Association Between Estimated Glomerular Filtration Rate and Microvascular Complications in Type II Diabetes Mellitus Patients: A 1-Year Cross-Sectional Study

Cited by 11 publications

References 25 publications

Global trend of diabetes mortality attributed to vascular complications, 2000–2016

Global trend of diabetes mortality attributed to vascular complications, 2000–2016

Prevalence of Vascular Complications Among Type 2 Diabetic Patients in a Rural Health Center in South India

Vascular endothelial growth factor expression in diabetic nephropathy; a clinico-pathological study

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