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Hosp Pract (1995). 2019 Feb;47(1):46-52. doi: 10.1080/21548331.2019.1549916. Epub 2018 Nov 25.

The association between renal function and neurological diseases in type 2 diabetes: a multicenter nationwide cross-sectional study.

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a Department of Military and Community Medicine , Phramongkutklao College of Medicine , Bangkok , Thailand.
b Division of Nephrology and Hypertension , Department of Internal Medicine, Mayo Clinic , Rochester , MN , USA.
c Department of Medicine , Phramongkutklao Hospital and College of Medicine , Bangkok , Thailand.
d Division of Nephrology, Department of Medicine , University of Mississippi Medical Center , Jackson , MS , USA.



The evidence for an association between renal function and neurological diseases among type 2 diabetes mellitus (T2DM) patients, particularly in the Asian population, is limited. This study aimed to assess the association between glomerular filtration rate (GFR) and various neurological diseases among T2DM patients in Thailand using a nationwide patient sample.


We conducted a nationwide cross-sectional study based on the DM/HT study of the Medical Research Network of the Consortium of Thai Medical Schools. This study evaluated adult T2DM patients receiving care at public Thailand hospitals in the year 2014. GFR was categorized into ≥60, 30-59, and < 30 mL/min/1.73 m2. Neurological diseases studied included ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, dementia, all cerebrovascular disease, and peripheral neuropathy. Multivariate logistic regression was performed to assess the association between GFR and neurological diseases.


A total of 30,423 T2DM patients with available GFR data were included in the analysis. The mean GFR was 68.18 ± 26.45 mL/min/1.73 m2. The prevalence of ischemic stroke/TIA, hemorrhagic stroke, dementia, any cerebrovascular diseases and peripheral neuropathy were 2.9%, 0.3%, 0.1%, 3.2%, and 3.1%, respectively. Patients with GFR of 30-59 and <30 mL/min/1.73 m2 were significantly associated with increased rates of ischemic stroke/TIA, any cerebrovascular diseases, and peripheral neuropathy when compared with patients with GFR of ≥60 mL/min/1.73 m2. This association remained significant after adjustment for potential confounders.


Decreased GFR was associated with increased ischemic stroke/TIA, all cerebrovascular diseases, and peripheral neuropathy. GFR should be monitored in diabetic patients for neurological disease awareness and prevention.


Diabetes mellitus; cerebrovascular disease; chronic kidney disease; dementia; glomerular filtration rate; peripheral neuropathy

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