Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe

Griffin, Tomás P.; O’Shea, Paula; Smyth, Andrew; Islam, Nahidul; Wall, Deirdre; Ferguson, John; O'Sullivan, Esther; Finucane, Francis; Dinneen, Seán F.; Dunne, Fidelma; Lappin, David; Reddan, Donal; Bell, Marcia; O’Brien, Timothy; Griffin, D.; Griffin, Matthew

doi:10.1136/bmjdrc-2021-002125

Cited by 17 publications

(8 citation statements)

References 61 publications

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“…Microalbuminuria is often used as an early marker for diabetic kidney disease detected via the urine ACr and proteinuria (urine dipsticks) as the hallmark of kidney disease. 42 Besides glycaemic monitoring, renal function monitoring has been identified as the main factor in the preventing the development of renal failure. 43 Furthermore, in the presence of diabetes, there is a more rapid decline in renal function worsening with poor control.…”

Section: Discussionmentioning

confidence: 99%

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Ohanson

Pretorius

2023

S Afr Fam Pract

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Background: Diabetes mellitus is increasing globally and is associated with multiple complications. Guidelines have been formulated to standardise care among people living with diabetes mellitus (DM), but research shows poor compliance with treatment guidelines. The aim of this study was to assess how well healthcare practitioners in a district hospital in Gauteng complied with the most recent diabetic treatment guideline, Society for Endocrinology Metabolism and Diabetes South Africa (SEMDSA) 2017.Methods: A retrospective cross-sectional review of patient record living with diabetes was done. This study was conducted in the out-patient department of Dr Yusuf Dadoo hospital in the West Rand, Gauteng. A total of 323 records of patients seen from August 2019 to December 2019 were reviewed, and some of the basic variables were assessed according to the most recent diabetic treatment guidelines SEMDSA 2017.Results: Files were audited in four categories: comorbidities, examinations, investigations and the presence of complications. Six monthly glycated haemoglobin (HbA1c) was assessed in 40 (12.4%), annual creatinine assessed in 179 (55.4%) and lipogram in 154 (47.7%) of patients. More than 70% of patients had uncontrolled glycaemia and two people were screened for erectile dysfunction.Conclusion: Monitoring and control parameters were infrequently done as per guideline recommendations. The resultant effects were poor glycaemic control and thus numerous complications.Contribution: Targeted strategies to improve medical practitioner compliance to guidelines including further research to study factors associated with poor compliance with guidelines are needed to improve the overall care of people living with DM in the West Rand and thus minimise the risk of complications among patients in the district.

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Section: Discussionmentioning

confidence: 99%

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Ohanson

Pretorius

2023

S Afr Fam Pract

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“…The dataset contains the datapoints as shown in table 1. It was previously used in a study looking at the prevalence of diabetic kidney disease and rapid renal function decline in adults with diabetes (40).…”

Section: Methodsmentioning

confidence: 99%

Study Protocol- The impact of social deprivation on development and progression of diabetic kidney disease

Casey,

Buckley,

Kearney

et al. 2024

Preprint

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Introduction Diabetes is one of the leading causes of chronic kidney disease. Social deprivation is recognised as a risk factor for complications of diabetes, including diabetic kidney disease. The effect of deprivation on rate of decline in renal function has not been explored in the Irish Health System to date. The objective of this study is to explore the association between social deprivation and the development/progression of diabetic kidney disease in a cohort of adults living with diabetes in Ireland. Methods and analysis This is a retrospective cohort study using an existing dataset of people living with diabetes who attended the diabetes centre at University Hospital Galway from 2012 to 2016. The variables included in this dataset include demographic variables, type and duration of diabetes, clinical variables such as medication use, blood pressure and BMI and laboratory data including creatinine, urine albumin to creatinine to ratio, haemoglobin A1c and lipids. This dataset will be updated with laboratory data until January 2023. Individual’s addresses will be used to calculate deprivation indices using the Pobal Haase Pratschke (HP) deprivation index. Rate of renal function decline will be calculated using linear mixed-effect models. The relationship between deprivation and renal function will be assessed using linear regression (absolute and relative rate of renal function decline based on eGFR) and logistic regression models (rapid vs. non-rapid decline). Ethics and dissemination Ethical approval has been granted by the clinical research ethics committee of Galway University Hospitals- Ref C.A. 2956. Results will be presented at conferences and published in peer review journals.

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“…According to a Chinese epidemiological report, the overall prevalence of DKD was 3.5% among urban residents and 2.9% among rural residents in Central China in 2018 ( 4 , 5 ). Compared to those with type 1 diabetes, a greater proportion of patients with type 2 diabetes (T2D) have DKD ( 6 ). DKD often goes unnoticed because of its insidious onset, unremarkable early symptoms, and inadequate patient awareness, and the morbidity of DKD is often underestimated for this reasons.…”

Section: Introductionmentioning

confidence: 99%

Association between the triglyceride glucose index, triglyceride-glucose body mass index and diabetic kidney disease in adults with newly diagnosed type 2 diabetes

Jiang,

Lai

2024

Front. Med.

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BackgroundThe triglyceride glucose (TyG) index has been proved to be a reliable marker of diabetic kidney disease (DKD).ObjectiveWe further investigated the association between TyG index, and its derivative, triglyceride-glucose body mass index (TyG-BMI), and the risk of DKD among adults with newly diagnosed type 2 diabetes (T2D).MethodsThis cross-sectional study was conducted among patients with newly diagnosed T2D. We assessed the correlation between TyG index, TyG-BMI, and the risk of DKD using logistic regression analysis, restricted cubic spline analysis, trend tests, receiver operating characteristic curve, and subgroup analyses.ResultsAmong the 924 included patients, 199 (21.5%) had DKD. Logistic regression revealed that TyG index (odds ratio [OR] 1.232, 95% confidence interval [CI] 1.064–1.428, p = 0.005) and TyG-BMI (OR 1.003, 95% CI 1.000–1.006, p = 0.021) were risk factors for DKD. The trend test demonstrated a dose–response association between TyG index (p for trend = 0.004), TyG-BMI (p for trend = 0.035), and the risk of DKD. Restricted cubic spline analysis indicated a nonlinear correlation between TyG index and the risk of DKD, with an increase in the risk of DKD when the TyG index was greater than 9.68 (p for nonlinearity = 0.014). In contrast, TyG-BMI and the risk of DKD exhibited a linear dose–response relationship, with an increase in the risk of DKD when the TyG-BMI was greater than 243 (p for nonlinearity = 0.034). According to the receiver operating characteristic curve, the optimal cutoff values for TyG index and TyG-BMI were 10.08 and 221.5, respectively.ConclusionAmong newly diagnosed T2D patients, the risk of DKD increases with the increase of TyG index and TyG-BMI, with their respective cut-off values being 9.68 and 243. Both TyG index and TyG-BMI have poor diagnostic value for the risk of DKD.

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Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe

Cited by 17 publications

References 61 publications

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Compliance of medical practitioners with diabetic treatment guidelines in West Rand, Gauteng

Study Protocol- The impact of social deprivation on development and progression of diabetic kidney disease

Association between the triglyceride glucose index, triglyceride-glucose body mass index and diabetic kidney disease in adults with newly diagnosed type 2 diabetes

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