Type 2 diabetes and cardiorenal syndromes. A nationwide French hospital cohort study

Maisons, Valentin; Fauchier, Grégoire; Fréminville, Jean-Baptiste de; Goin, Nicolas; Gueguen, Juliette; Gatault, Philippe; Sautenet, Bénédicte; Angoulvant, Denis; Herbert, Julien; Bisson, Arnaud; Ducluzeau, Pierre-Henri; Fauchier, Laurent

doi:10.1016/j.diabet.2023.101441

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…However, these are also risk factors for atherosclerosis and macrovascular lesions. As we have already shown in a previous study, diabetes is a major risk factor for CRS [23]. However, diabetes with (cluster 1) or without (cluster 3) severe macrovascular damage may lead to CRS by different pathophysiological pathways: primary ischemic lesions in the first case and primary microvascular dysfunction in the second case.…”

Section: Discussionmentioning

confidence: 60%

“…All medical procedures are also recorded using the national nomenclature, Classification Commune des Actes Medicaux (CCAM). The reliability of the PMSI data has been previously assessed [22], and this database has been effectively used in previous studies related to cardiovascular or cerebrovascular conditions [5,23] The study was conducted retrospectively, and, as the patients were not involved in its conduct, there was no impact on their care. Ethical approval was not required, as all data were anonymized.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Unsupervised Cluster Analysis in Patients with Cardiorenal Syndromes: Identifying Vascular Aspects

de Freminville,

Halimi,

Maisons

et al. 2024

JCM

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Background/Objectives: Cardiorenal syndrome (CRS) is a disorder of the heart and kidneys, with one type of organ dysfunction affecting the other. The pathophysiology is complex, and its actual description has been questioned. We used clustering analysis to identify clinically relevant phenogroups among patients with CRS. Methods: Data for patients admitted from 1 January 2012 to 31 December 2012 were collected from the French national medico-administrative database. Patients with a diagnosis of heart failure and chronic kidney disease and at least 5 years of follow-up were included. Results: In total, 13,665 patients were included and four clusters were identified. Cluster 1 could be described as the vascular–diabetes cluster. It comprised 1930 patients (14.1%), among which 60% had diabetes, 94% had coronary artery disease (CAD), and 80% had peripheral artery disease (PAD). Cluster 2 could be described as the vascular cluster. It comprised 2487 patients (18.2%), among which 33% had diabetes, 85% had CAD, and 78% had PAD. Cluster 3 could be described as the metabolic cluster. It comprised 2163 patients (15.8%), among which 87% had diabetes, 67% dyslipidemia, and 62% obesity. Cluster 4 comprised 7085 patients (51.8%) and could be described as the low-vascular cluster. The vascular cluster was the only one associated with a higher risk of cardiovascular death (HR: 1.48 [1.32–1.66]). The metabolic cluster was associated with a higher risk of kidney replacement therapy (HR: 1.33 [1.17–1.51]). Conclusions: Our study supports a new classification of CRS based on the vascular aspect of pathophysiology differentiating microvascular or macrovascular lesions. These results could have an impact on patients’ medical treatment.

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Section: Discussionmentioning

confidence: 60%

Section: Methodsmentioning

confidence: 99%

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Unsupervised Cluster Analysis in Patients with Cardiorenal Syndromes: Identifying Vascular Aspects

de Freminville,

Halimi,

Maisons

et al. 2024

JCM

Self Cite

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“…A supplementary study by the same researchers found that among patients with CRS, half were diagnosed with diabetes mellitus. Additionally, the presence of type 2 diabetes mellitus was associated with a doubling of the risk for CRS and tended to affect patients at a younger age [ 87 ].…”

Section: From Epidemiology To a Vicious Cycle Of Cardiorenal Interactionmentioning

confidence: 99%

Unraveling Chronic Cardiovascular and Kidney Disorder through the Butterfly Effect

Bedo,

Beaudrey,

Florens

2024

Diagnostics

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Chronic Cardiovascular and Kidney Disorder (CCKD) represents a growing challenge in healthcare, characterized by the complex interplay between heart and kidney diseases. This manuscript delves into the “butterfly effect” in CCKD, a phenomenon in which acute injuries in one organ lead to progressive dysfunction in the other. Through extensive review, we explore the pathophysiology underlying this effect, emphasizing the roles of acute kidney injury (AKI) and heart failure (HF) in exacerbating each other. We highlight emerging therapies, such as renin–angiotensin–aldosterone system (RAAS) inhibitors, SGLT2 inhibitors, and GLP1 agonists, that show promise in mitigating the progression of CCKD. Additionally, we discuss novel therapeutic targets, including Galectin-3 inhibition and IL33/ST2 pathway modulation, and their potential in altering the course of CCKD. Our comprehensive analysis underscores the importance of recognizing and treating the intertwined nature of cardiac and renal dysfunctions, paving the way for more effective management strategies for this multifaceted syndrome.

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Early diagnosis of chronic kidney disease in patients with diabetes in France: multidisciplinary expert opinion, prevention value and practical recommendations

Hannedouche,

Rossignol,

Darmon

et al. 2023

Postgraduate Medicine

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Type 2 diabetes and cardiorenal syndromes. A nationwide French hospital cohort study

Cited by 3 publications

References 31 publications

Unsupervised Cluster Analysis in Patients with Cardiorenal Syndromes: Identifying Vascular Aspects

Unsupervised Cluster Analysis in Patients with Cardiorenal Syndromes: Identifying Vascular Aspects

Unraveling Chronic Cardiovascular and Kidney Disorder through the Butterfly Effect

Early diagnosis of chronic kidney disease in patients with diabetes in France: multidisciplinary expert opinion, prevention value and practical recommendations

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