1. Nonalbuminuric Diabetic Kidney Disease and Risk of All-Cause Mortality and Cardiovascular and Kidney Outcomes in Type 2 Diabetes: Findings From the Hong Kong Diabetes Biobank
- Author
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Jin, Qiao, Luk, Andrea O., Lau, Eric S.H., Tam, Claudia H.T., Ozaki, Risa, Lim, Cadmon K.P., Wu, Hongjiang, Jiang, Guozhi, Chow, Elaine Y.K., Ng, Jack K., Kong, Alice P.S., Fan, Baoqi, Lee, Ka Fai, Siu, Shing Chung, Hui, Grace, Tsang, Chiu Chi, Lau, Kam Piu, Leung, Jenny Y., Tsang, Man-Wo, Kam, Grace, Lau, Ip Tim, Li, June K., Yeung, Vincent T., Lau, Eric S., Lo, Stanley, Fung, Samuel, Cheng, Yuk Lun, Chow, Chun Chung, Huang, Yu, Lan, Hui-yao, Szeto, Cheuk Chun, So, Wing Yee, Chan, Juliana C.N., Ma, R.C.W., Poo Lim, Cadmon King, Cheung, Elaine, Li, Kam-Yin, Yeung, Vincent T.F., Tsui, Stephen Kwok-Wing, Yu, Weichuan, Tomlinson, Brian, Lok, Si, Chan, Ting Fung, Yip, Kevin Yuk-lap, Fan, Xiaodan, Tang, Nelson L.S., Tian, Xiaoyu, Mai, Shi, Xie, Fei, Zhang, Sen, Yu, Pu, Wang, Meng, Lee, Heung Man, Ng, Alex C.W., Cheung, Grace, Yeung, Ming Wai, Cheung, Kitty K.T., Wong, Rebecca Y.M., Cheong, So Hon, Chan, Katie K.H., Law, Chin-San, Yuen Lock, Anthea Ka, Ying Tsang, Ingrid Kwok, Pun Chan, Susanna, Chan, Yin Wah, Chiu, Cherry, Hung, Chi Sang, Ho, Cheuk Wah, Yee Ng, Ivy Hoi, Chun Fok, Juliana Mun, Lee, Ka Wah, Candy Leung, Hoi Sze, Chan, Hui Ming, Wat, Winnie, Lau, Tracy, Law, Rebecca, Chan, Ryan, Lau, Candice, Tsang, Pearl, Chan, Vince, Ho, Lap Ying, Wong, Eva, Chan, Josephine, Lam, Sau Fung, Pang, Jessy, Lee, Yee Mui, Hong Kong Diabetes Biobank Study, Group, Jin, Qiao, Luk, Andrea O., Lau, Eric S.H., Tam, Claudia H.T., Ozaki, Risa, Lim, Cadmon K.P., Wu, Hongjiang, Jiang, Guozhi, Chow, Elaine Y.K., Ng, Jack K., Kong, Alice P.S., Fan, Baoqi, Lee, Ka Fai, Siu, Shing Chung, Hui, Grace, Tsang, Chiu Chi, Lau, Kam Piu, Leung, Jenny Y., Tsang, Man-Wo, Kam, Grace, Lau, Ip Tim, Li, June K., Yeung, Vincent T., Lau, Eric S., Lo, Stanley, Fung, Samuel, Cheng, Yuk Lun, Chow, Chun Chung, Huang, Yu, Lan, Hui-yao, Szeto, Cheuk Chun, So, Wing Yee, Chan, Juliana C.N., Ma, R.C.W., Poo Lim, Cadmon King, Cheung, Elaine, Li, Kam-Yin, Yeung, Vincent T.F., Tsui, Stephen Kwok-Wing, Yu, Weichuan, Tomlinson, Brian, Lok, Si, Chan, Ting Fung, Yip, Kevin Yuk-lap, Fan, Xiaodan, Tang, Nelson L.S., Tian, Xiaoyu, Mai, Shi, Xie, Fei, Zhang, Sen, Yu, Pu, Wang, Meng, Lee, Heung Man, Ng, Alex C.W., Cheung, Grace, Yeung, Ming Wai, Cheung, Kitty K.T., Wong, Rebecca Y.M., Cheong, So Hon, Chan, Katie K.H., Law, Chin-San, Yuen Lock, Anthea Ka, Ying Tsang, Ingrid Kwok, Pun Chan, Susanna, Chan, Yin Wah, Chiu, Cherry, Hung, Chi Sang, Ho, Cheuk Wah, Yee Ng, Ivy Hoi, Chun Fok, Juliana Mun, Lee, Ka Wah, Candy Leung, Hoi Sze, Chan, Hui Ming, Wat, Winnie, Lau, Tracy, Law, Rebecca, Chan, Ryan, Lau, Candice, Tsang, Pearl, Chan, Vince, Ho, Lap Ying, Wong, Eva, Chan, Josephine, Lam, Sau Fung, Pang, Jessy, Lee, Yee Mui, and Hong Kong Diabetes Biobank Study, Group
- Abstract
Rationale & Objective: Nonalbuminuric diabetic kidney disease (DKD) has become the prevailing DKD phenotype. We compared the risks of adverse outcomes among patients with this phenotype compared with other DKD phenotypes. Study Design: Multicenter prospective cohort study. Settings & Participants: 19,025 Chinese adults with type 2 diabetes enrolled in the Hong Kong Diabetes Biobank. Exposures: DKD phenotypes defined by baseline estimated glomerular filtration rate (eGFR) and albuminuria: no DKD (no decreased eGFR or albuminuria), albuminuria without decreased eGFR, decreased eGFR without albuminuria, and albuminuria with decreased eGFR. Outcomes: All-cause mortality, cardiovascular disease (CVD) events, hospitalization for heart failure (HF), and chronic kidney disease (CKD) progression (incident kidney failure or sustained eGFR reduction ≥40%). Analytical Approach: Multivariable Cox proportional or cause-specific hazards models to estimate the relative risks of death, CVD, hospitalization for HF, and CKD progression. Multiple imputation was used for missing covariates. Results: Mean participant age was 61.1 years, 58.3% were male, and mean diabetes duration was 11.1 years. During 54,260 person-years of follow-up, 438 deaths, 1,076 CVD events, 298 hospitalizations for HF, and 1,161 episodes of CKD progression occurred. Compared with the no-DKD subgroup, the subgroup with decreased eGFR without albuminuria had higher risks of all-cause mortality (hazard ratio [HR], 1.59 [95% CI, 1.04-2.44]), hospitalization for HF (HR, 3.08 [95% CI, 1.82-5.21]), and CKD progression (HR, 2.37 [95% CI, 1.63-3.43]), but the risk of CVD was not significantly greater (HR, 1.14 [95% CI, 0.88-1.48]). The risks of death, CVD, hospitalization for HF, and CKD progression were higher in the setting of albuminuria with or without decreased eGFR. A sensitivity analysis that excluded participants with baseline eGFR <30 mL/min/1.73 m2 yielded similar findings. Limitations: Potential misc
- Published
- 2022