Format

Send to

Choose Destination
J Am Soc Nephrol. 2011 Mar;22(3):537-44. doi: 10.1681/ASN.2010020194. Epub 2011 Feb 18.

Competing-risk analysis of ESRD and death among patients with type 1 diabetes and macroalbuminuria.

Author information

1
Folkhälsan Research Center, Biomedicum Helsinki, Haartmaninkatu 8, University of Helsinki, Finland.

Abstract

Patients with both type 1 diabetes and CKD have an increased risk of adverse outcomes. The competing risks of death and ESRD may confound the estimates of risk for each outcome. Here, we sought to determine the major predictors of the cumulative incidence of ESRD and pre-ESRD mortality in patients with type 1 diabetes and macroalbuminuria while incorporating the competing risk for the alternate outcome into a Fine-Gray competing-risks analysis. We followed 592 patients with macroalbuminuria for a median of 9.9 years. During this time, 56 (9.5%) patients died and 210 (35.5%) patients developed ESRD. Predictors of incident ESRD, taking baseline renal function and the competing risk for death into account, included an elevated HbA(1c), elevated LDL cholesterol, male sex, weight-adjusted insulin dose, and a shorter duration of diabetes. By contrast, predictors of pre-ESRD death, taking baseline renal function and the competing risk for ESRD into account, included only age, the presence of established macrovascular disease, and elevated cholesterol levels. This competing-risks approach has potential to highlight the appropriate targets and strategies for preventing premature mortality in patients with type 1 diabetes.

PMID:
21335512
PMCID:
PMC3060447
DOI:
10.1681/ASN.2010020194
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center