Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality
Introduction: Individuals with type 1 diabetes (T1D) and diabetic nephropathy (DN) experience progressive kidney function decline and high risk of cardiovascular disease (CVD) and mortality. This study explored changes in kidney function decline in new-onset DN between 2000 and 2020 and provided an...
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Elsevier
2024-12-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924019387 |
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| author | Christina G. Poulsen Kristin Jesse Bendix Carstensen Marie Frimodt-Møller Tine W. Hansen Frederik Persson Dorte Vistisen Peter Rossing |
| author_facet | Christina G. Poulsen Kristin Jesse Bendix Carstensen Marie Frimodt-Møller Tine W. Hansen Frederik Persson Dorte Vistisen Peter Rossing |
| author_sort | Christina G. Poulsen |
| collection | DOAJ |
| description | Introduction: Individuals with type 1 diabetes (T1D) and diabetic nephropathy (DN) experience progressive kidney function decline and high risk of cardiovascular disease (CVD) and mortality. This study explored changes in kidney function decline in new-onset DN between 2000 and 2020 and provided an updated prognosis for risk of kidney failure, CVD, and mortality. Methods: This is a register-based cohort study in T1D with new-onset DN (severely increased albuminuria) between 2000 and 2020 at Steno Diabetes Center Copenhagen, Denmark. Data were derived from electronic health records and national registers. Kidney function development was expressed as trajectories of estimated glomerular filtration rate (eGFR) and measured GFR (mGFR) using mixed-effects models. The prognosis was presented in probabilities of developing complications, stratified by sex, prior CVD, and risk factor control by using simulations based on Poisson regression analysis. Results: The cohort comprised 591 individuals with median (interquartile range [IQR]) age at DN onset of 53 (39–66) years and 57% were male. In 283 participants, mGFR were available. Plots of eGFR trajectories illustrated tendencies toward higher eGFR in more recent years; however, this was not confirmed in mGFR trajectories. Poor risk factor control, prior CVD, and male sex impacted mortality and morbidity rates negatively. For men and women with fair risk factor control and no prior CVD, the 10-year mortality rate from onset of DN was 28% and 26%, respectively. For men and women with poor risk factor control and CVD prior to DN onset, the 10-year-mortality rate was 62% for each sex. Conclusion: The results do not support an improved prognosis for T1D and DN, emphasizing the urgent need for new therapeutic approaches. |
| format | Article |
| id | doaj-art-0784689b2d15407bbbeb8cd33c8d7f7b |
| institution | Kabale University |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-0784689b2d15407bbbeb8cd33c8d7f7b2025-08-20T03:47:09ZengElsevierKidney International Reports2468-02492024-12-019123403341310.1016/j.ekir.2024.09.010Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and MortalityChristina G. Poulsen0Kristin Jesse1Bendix Carstensen2Marie Frimodt-Møller3Tine W. Hansen4Frederik Persson5Dorte Vistisen6Peter Rossing7Complications Research, Steno Diabetes Center Copenhagen, Herlev, Denmark; Correspondence: Christina Gjerlev Poulsen, Complications Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, DK-Denmark.Clinical Epidemiological Research, Steno Diabetes Center Copenhagen, Herlev, DenmarkClinical Epidemiological Research, Steno Diabetes Center Copenhagen, Herlev, DenmarkComplications Research, Steno Diabetes Center Copenhagen, Herlev, DenmarkComplications Research, Steno Diabetes Center Copenhagen, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkComplications Research, Steno Diabetes Center Copenhagen, Herlev, DenmarkClinical Epidemiological Research, Steno Diabetes Center Copenhagen, Herlev, Denmark; Novo Nordisk Denmark A/S, Copenhagen, DenmarkComplications Research, Steno Diabetes Center Copenhagen, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkIntroduction: Individuals with type 1 diabetes (T1D) and diabetic nephropathy (DN) experience progressive kidney function decline and high risk of cardiovascular disease (CVD) and mortality. This study explored changes in kidney function decline in new-onset DN between 2000 and 2020 and provided an updated prognosis for risk of kidney failure, CVD, and mortality. Methods: This is a register-based cohort study in T1D with new-onset DN (severely increased albuminuria) between 2000 and 2020 at Steno Diabetes Center Copenhagen, Denmark. Data were derived from electronic health records and national registers. Kidney function development was expressed as trajectories of estimated glomerular filtration rate (eGFR) and measured GFR (mGFR) using mixed-effects models. The prognosis was presented in probabilities of developing complications, stratified by sex, prior CVD, and risk factor control by using simulations based on Poisson regression analysis. Results: The cohort comprised 591 individuals with median (interquartile range [IQR]) age at DN onset of 53 (39–66) years and 57% were male. In 283 participants, mGFR were available. Plots of eGFR trajectories illustrated tendencies toward higher eGFR in more recent years; however, this was not confirmed in mGFR trajectories. Poor risk factor control, prior CVD, and male sex impacted mortality and morbidity rates negatively. For men and women with fair risk factor control and no prior CVD, the 10-year mortality rate from onset of DN was 28% and 26%, respectively. For men and women with poor risk factor control and CVD prior to DN onset, the 10-year-mortality rate was 62% for each sex. Conclusion: The results do not support an improved prognosis for T1D and DN, emphasizing the urgent need for new therapeutic approaches.http://www.sciencedirect.com/science/article/pii/S2468024924019387albuminuriacardiovascular diseasediabetesdiabetic nephropathymortality |
| spellingShingle | Christina G. Poulsen Kristin Jesse Bendix Carstensen Marie Frimodt-Møller Tine W. Hansen Frederik Persson Dorte Vistisen Peter Rossing Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality Kidney International Reports albuminuria cardiovascular disease diabetes diabetic nephropathy mortality |
| title | Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality |
| title_full | Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality |
| title_fullStr | Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality |
| title_full_unstemmed | Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality |
| title_short | Prognosis for Type 1 Diabetes with Diabetic Nephropathy between 2000 and 2020 - Changes in Kidney Function Decline Over Time and Development of Cardiovascular Disease, Kidney Failure, and Mortality |
| title_sort | prognosis for type 1 diabetes with diabetic nephropathy between 2000 and 2020 changes in kidney function decline over time and development of cardiovascular disease kidney failure and mortality |
| topic | albuminuria cardiovascular disease diabetes diabetic nephropathy mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924019387 |
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