Progression of chronic kidney disease in a multi‐ethnic community cohort of patients with diabetes mellitus

Abstract

Objective The present study investigates the impact of quality of care (QoC) and other factors on chronic kidney disease (CKD) stage progression among Type 2 Diabetes Mellitus (T2DM) patients. Methods This study employed a retrospective cohort from a nationwide Diabetes and Hypertension study involving 595 Thai hospitals. T2DM patients who were observed at least 2 times in the 3 years follow-up (between 2011-2013) were included in our study. Ordinal logistic mixed effect regression modeling was used to investigate the association between the QoC and other factors with CKD stage progression. Results After adjusting for covariates, we found that the achievement of the HbA1c clinical targets (7%) was the only QoC indicator protective against the CKD stage progression (adjusted OR = 0.76; 95%CI = 0.59-0.98; p<0.05). In terms of other covariates, age, occupation, type of health insurance, region of residence, HDL-C, triglyceride, hypertension and insulin sen-sitizer were also strongly associated with CKD stage progression.

Is there a difference in progression of renal disease between South Asian and white European diabetic adults with moderately reduced kidney function?

“…Our findings did not confirm the observations made by previous studies that there is more rapid progression of CKD in South Asian patients (Burden et al, 1992;Dreyer et al, 2013;Roderick et al, 1996). While these studies revealed significantly increased acceptance rates for renal replacement treatment in Asian and black populations, possible data inaccuracies, true increase in incidence and prevalence of underlying diseases, different genetic and environmental susceptibility to progression of CKD, referral for treatment, and access factors may have contributed to this discrepancy.…”

“…Very little data are available regarding ethnic differences in DN in more contemporary populations, benefitting from more modern approaches to diabetes management. Recently, Dreyer, Hull, Mathur, Chesser, and Yaqoob (2013) examined differences in renal decline between South Asian and White European patients with DM in the primary care setting. They observed a 0.31 ml/min/1.73 m 2 greater decline in estimated glomerular filtration rate (eGFR) in the South Asian population.…”

Evaluating ethnic differences in the prescription of NSAIDs for chronic kidney disease: a cross-sectional survey of patients in general practice

“…7 In November 2012, demographic, clinical, and prescribing data were extracted for all patients aged ≥18 years, registered with 102 general practices across Tower Hamlets, Newham, and City & Hackney. All data were anonymous and managed according to UK NHS information governance requirements.…”

The association between body composition and cystatin C in South Asians: Results from the MASALA study

“…Chronic kidney disease (CKD) is of great concern in South Asians (SAs), a population with a high prevalence of diabetes, hypertension and kidney disease progression [1,2]. Obesity is a risk factor for CKD, but less is known about the role of regional body composition [3].…”