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J Diabetes Complications. 2016 Mar;30(2):227-36. doi: 10.1016/j.jdiacomp.2015.10.007. Epub 2015 Oct 21.

Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease.

Author information

1
Gerencia Adjunta de Planificación y Calidad, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain. Electronic address: miguel.salinero@salud.madrid.org.
2
Centro de Salud Las Calesas, Servicio Madrileño de Salud, Madrid, Spain.
3
Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain; Servicio de Medicina Preventiva, Hospital Universitario La Paz, Servicio Madrileño de Salud, Madrid, Spain.
4
Gerencia Adjunta de Planificación y Calidad, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain.
5
Centro Nacional de Investigaciones Oncológicas, Madrid, Spain.
6
Hospital Central de la Defensa, Madrid, Spain.
7
Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
8
Aging and fragility in the elderly Group, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Plataforma de Apoyo al Investigador Novel-PAIN Platform, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain.

Abstract

AIMS:

To assess the prevalence of stage 3-5 chronic kidney disease (CKD) at baseline and to identify associated risk factors. To determine the effect of CKD and CKD stage according to estimated glomerular filtration rate (eGFR) and albuminuria categories on all-cause and cardiovascular mortality after a 5-year follow-up.

METHODS:

Prospective cohort study of 3443 outpatients with type 2 diabetes mellitus.

RESULTS:

The prevalence of CKD was 28.32% (95% CI, 26.84-29.86); and variables most strongly associated were: age >74 years (OR, 19.88; 95% CI, 12.89-30.68) and albuminuria (OR, 2.27; 95% CI, 1.72-3.00). During follow-up, 221 CKD patients (22.90%) died compared with 203 non-CKD patients (8.31%) (p<0.01). The adjusted HR of CKD for cardiovascular and all-cause mortality was 1.82 (95% CI, 1.36-2.44) and 2.11 (95% CI, 1.61-2.76) for those with LDL cholesterol =135 mg/dl, respectively. The adjusted HR of very-high-risk CKD for all-cause mortality was 4.44 (95% CI, 2.31-8.53) in aged <75 years and 1.80 (95% CI, 1.19-2.72) in aged ≥75 years.

CONCLUSIONS:

CKD at baseline is an independent risk factor for all-cause and cardiovascular mortality in the overall cohort, men and women, or in primary and secondary prevention of coronary heart disease. Albuminuria is an independent risk factor for all-cause and cardiovascular mortality only in primary prevention.

KEYWORDS:

Cohort studies; Diabetes complications; Diabetes mellitus, type 2; Kidney diseases; Mortality

PMID:
26627635
DOI:
10.1016/j.jdiacomp.2015.10.007
[Indexed for MEDLINE]
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