Chronic Kidney Disease

CKD Onset in Patients With Type 1 Diabetes: What Are the Factors?

Patients with type 1 diabetes and poor cardiovascular (CV) risk profile are at a high risk of developing chronic kidney disease (CKD), according to a recent study.

The retrospective study evaluated 2656 patients with type 1 diabetes and preserved renal function at baseline who were included in the Italian Association of Clinical Diabetologists database. The researchers followed patients for 5 years and measured estimated glomerular filtration rate (eGFR), urinary albumin excretion, HbA1c level, lipid levels, and blood pressure.
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Over the 5 years of follow-up, 115 patients (4.3%) had developed reduced eGFR, 447 (18%) had albuminuria, and 559 (21%) had developed CKD.  

The odds ratios for eGFR below 90 mL/min/1.73, HbA1C, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were independently associated with the onset of chronic kidney disease.

In addition, known duration of diabetes, HbA1C, triglycerides, LDL-C, and antihypertensive treatment were related to the onset of albuminuria. The development of reduced eGFR was independently affected by age and the presence of baseline eGFR values between 90 and 60 mL/min/1.73 m2.

“Patients with type 1 diabetes mellitus and unfavorable CV risk profile are at high risk of developing CKD,” the researchers concluded. “The two main traits of CKD share several determinants, although with some specificities.”

—Melissa Weiss

Reference:

Piscitelli P, Viazzi F, Fioretto P, et al. Predictors of chronic kidney disease in type 1 diabetes: a longitudinal study from the AMD Annals initiative [published online June 12, 2017]. Sci Rep. doi:10.1038/s41598-017-03551-w.