THE PRESENCE AND SEVERITY OF CHRONIC KIDNEY DISEASE PREDICTS ALL-CAUSE MORTALITY IN TYPE 1 DIABETES. Export

@article{citeulike:4469995, abstract = {Objectives: This study aims to identify clinical features associated with premature mortality in a large contemporary cohort of adults with type 1 diabetes. Research Design and Methods: The Finn Diane study is a national multi-centre, prospective, follow-up study of 4,201 adults with type 1 diabetes, from 21 university and central hospitals, 33 district hospitals, and 26 primary health care centres across Finland. Results - During a median 7 years of follow-up, there were 291 deaths (7\%), 3.6-fold (95\% CI, 3.2 - 4.0) more than observed in the age-gender matched general population. Excess mortality was only observed in individuals with chronic kidney disease. Individuals with normoalbuminuria showed no excess mortality beyond the general population (SMR 0.8, 95\% CI 0.5 -1.1), independent to the duration of diabetes. The presence of microalbuminuria, macroalbuminuria and end-stage kidney disease was associated with an increased standardised mortality ratio (SMR) of 2.8, 9.2 and 18.3 times respectively. The increase in mortality across each stage of albuminuria was equivalent to the risk conferred by pre-existing macrovascular disease. In addition, the glomerular filtration rate was independently associated with mortality, such that individuals with impaired kidney function, as well as those demonstrating hyperfiltration, had an increased risk of death. Conclusions: An independent, graded association was observed between the presence and severity of kidney disease and mortality in a large, contemporary cohort of individuals with type 1 diabetes. These findings highlight the clinical and public health importance of CKD and its prevention in the management of type 1 diabetes.}, author = {Groop, Per-Henrik H. and Thomas, Merlin C C. and Moran, John L L. and Wad\`{e}n, Johan and Thorn, Lena M M. and M\"{a}kinen, Ville-Petteri P. and Roseng\r{a}rd-B\"{a}rlund, Milla and Saraheimo, Markku and Hietala, Kustaa and Heikkil\"{a}, Outi and Forsblom, Carol and {}}, citeulike-article-id = {4469995}, citeulike-linkout-0 = {http://dx.doi.org/10.2337/db08-1543}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19401416}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19401416}, day = {28}, doi = {10.2337/db08-1543}, issn = {1939-327X}, journal = {Diabetes}, month = {April}, posted-at = {2009-05-06 11:42:28}, priority = {2}, title = {THE PRESENCE AND SEVERITY OF CHRONIC KIDNEY DISEASE PREDICTS ALL-CAUSE MORTALITY IN TYPE 1 DIABETES.}, url = {http://dx.doi.org/10.2337/db08-1543}, year = {2009} }

TY - JOUR ID - citeulike:4469995 L3 - citeulike-article-id:4469995 N2 - Objectives: This study aims to identify clinical features associated with premature mortality in a large contemporary cohort of adults with type 1 diabetes. Research Design and Methods: The Finn Diane study is a national multi-centre, prospective, follow-up study of 4,201 adults with type 1 diabetes, from 21 university and central hospitals, 33 district hospitals, and 26 primary health care centres across Finland. Results - During a median 7 years of follow-up, there were 291 deaths (7%), 3.6-fold (95% CI, 3.2 - 4.0) more than observed in the age-gender matched general population. Excess mortality was only observed in individuals with chronic kidney disease. Individuals with normoalbuminuria showed no excess mortality beyond the general population (SMR 0.8, 95% CI 0.5 -1.1), independent to the duration of diabetes. The presence of microalbuminuria, macroalbuminuria and end-stage kidney disease was associated with an increased standardised mortality ratio (SMR) of 2.8, 9.2 and 18.3 times respectively. The increase in mortality across each stage of albuminuria was equivalent to the risk conferred by pre-existing macrovascular disease. In addition, the glomerular filtration rate was independently associated with mortality, such that individuals with impaired kidney function, as well as those demonstrating hyperfiltration, had an increased risk of death. Conclusions: An independent, graded association was observed between the presence and severity of kidney disease and mortality in a large, contemporary cohort of individuals with type 1 diabetes. These findings highlight the clinical and public health importance of CKD and its prevention in the management of type 1 diabetes. JF - Diabetes SN - 1939-327X TI - THE PRESENCE AND SEVERITY OF CHRONIC KIDNEY DISEASE PREDICTS ALL-CAUSE MORTALITY IN TYPE 1 DIABETES. AU - Groop, Per-Henrik AU - Thomas, Merlin C AU - Moran, John L AU - Wadèn, Johan AU - Thorn, Lena M AU - Mäkinen, Ville-Petteri AU - Rosengård-Bärlund, Milla AU - Saraheimo, Markku AU - Hietala, Kustaa AU - Heikkilä, Outi AU - Forsblom, Carol PY - 2009/04/28/ UR - http://dx.doi.org/10.2337/db08-1543 ER -