Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes

Abstract Patients with diabetes are susceptible to acute kidney injury (AKI) as compared to counterparts without diabetes. However, data on the long-term clinical outcome of AKI specifically in people with diabetes are still scarce. We sought to study risk factors for and adverse cardio-renal outcom...

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Main Authors: Janus Lee, Jian-Jun Liu, Sylvia Liu, Allen Liu, Huili Zheng, Clara Chan, Yi Ming Shao, Resham L Gurung, Keven Ang, Su Chi Lim
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-77981-8
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author Janus Lee
Jian-Jun Liu
Sylvia Liu
Allen Liu
Huili Zheng
Clara Chan
Yi Ming Shao
Resham L Gurung
Keven Ang
Su Chi Lim
author_facet Janus Lee
Jian-Jun Liu
Sylvia Liu
Allen Liu
Huili Zheng
Clara Chan
Yi Ming Shao
Resham L Gurung
Keven Ang
Su Chi Lim
author_sort Janus Lee
collection DOAJ
description Abstract Patients with diabetes are susceptible to acute kidney injury (AKI) as compared to counterparts without diabetes. However, data on the long-term clinical outcome of AKI specifically in people with diabetes are still scarce. We sought to study risk factors for and adverse cardio-renal outcomes of AKI in multi-ethnic Southeast Asian people with type 2 diabetes. 1684 participants with type 2 diabetes from a regional hospital were followed an average of 4.2 (SD 2.0) years. Risks for end stage kidney disease (ESKD), major adverse cardiovascular events (MACE) and all-cause death after AKI were assessed by survival analyses. 219 participants experienced at least one AKI episode. Age, cardiovascular disease history, minor ethnicity, diuretics usage, HbA1c, baseline eGFR and albuminuria independently predicted risk for AKI with good discrimination. Compared to those without AKI, participants with any AKI episode had a significantly high risk for ESKD, MACE and all-cause death after adjustment for multiple risk factors including baseline eGFR and albuminuria. Even AKI defined by a mild serum creatinine elevation (0.3 mg/dL) was independently associated with a significantly high risk for premature death. Therefore, individuals with diabetes and any episode of AKI deserve intensive surveillance for cardio-renal dysfunction.
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spelling doaj-art-757469658ce749ccbaefa17032fe8ff92025-08-20T02:50:07ZengNature PortfolioScientific Reports2045-23222024-11-011411910.1038/s41598-024-77981-8Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetesJanus Lee0Jian-Jun Liu1Sylvia Liu2Allen Liu3Huili Zheng4Clara Chan5Yi Ming Shao6Resham L Gurung7Keven Ang8Su Chi Lim9Clinical Research Unit, Khoo Teck Puat HospitalClinical Research Unit, Khoo Teck Puat HospitalClinical Research Unit, Khoo Teck Puat HospitalDepartment of Medicine, Khoo Teck Puat hospitalClinical Research Unit, Khoo Teck Puat HospitalClinical Research Unit, Khoo Teck Puat HospitalClinical Research Unit, Khoo Teck Puat HospitalClinical Research Unit, Khoo Teck Puat HospitalClinical Research Unit, Khoo Teck Puat HospitalDepartment of Medicine, Khoo Teck Puat hospitalAbstract Patients with diabetes are susceptible to acute kidney injury (AKI) as compared to counterparts without diabetes. However, data on the long-term clinical outcome of AKI specifically in people with diabetes are still scarce. We sought to study risk factors for and adverse cardio-renal outcomes of AKI in multi-ethnic Southeast Asian people with type 2 diabetes. 1684 participants with type 2 diabetes from a regional hospital were followed an average of 4.2 (SD 2.0) years. Risks for end stage kidney disease (ESKD), major adverse cardiovascular events (MACE) and all-cause death after AKI were assessed by survival analyses. 219 participants experienced at least one AKI episode. Age, cardiovascular disease history, minor ethnicity, diuretics usage, HbA1c, baseline eGFR and albuminuria independently predicted risk for AKI with good discrimination. Compared to those without AKI, participants with any AKI episode had a significantly high risk for ESKD, MACE and all-cause death after adjustment for multiple risk factors including baseline eGFR and albuminuria. Even AKI defined by a mild serum creatinine elevation (0.3 mg/dL) was independently associated with a significantly high risk for premature death. Therefore, individuals with diabetes and any episode of AKI deserve intensive surveillance for cardio-renal dysfunction.https://doi.org/10.1038/s41598-024-77981-8Acute kidney injuryClinical risk predictorEnd stage kidney diseaseMajor adverse cardiovascular eventAll-cause mortalityType 2 diabetes
spellingShingle Janus Lee
Jian-Jun Liu
Sylvia Liu
Allen Liu
Huili Zheng
Clara Chan
Yi Ming Shao
Resham L Gurung
Keven Ang
Su Chi Lim
Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes
Scientific Reports
Acute kidney injury
Clinical risk predictor
End stage kidney disease
Major adverse cardiovascular event
All-cause mortality
Type 2 diabetes
title Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes
title_full Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes
title_fullStr Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes
title_full_unstemmed Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes
title_short Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes
title_sort acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast asian people with type 2 diabetes
topic Acute kidney injury
Clinical risk predictor
End stage kidney disease
Major adverse cardiovascular event
All-cause mortality
Type 2 diabetes
url https://doi.org/10.1038/s41598-024-77981-8
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