Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/84626
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Type: | Journal article |
Title: | The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes |
Author: | Groop, P. Thomas, M. Moran, J. Waden, J. Thorn, L. Makinen, V. Rosengard-Barlund, M. Saraheimo, M. Hietala, K. Heikkia, O. Forsblom, C. |
Citation: | Diabetes, 2009; 58(7):1651-1658 |
Publisher: | American Diabetes Association |
Issue Date: | 2009 |
ISSN: | 0012-1797 1939-327X |
Statement of Responsibility: | Per-Henrik Groop, Merlin C. Thomas, John L. Moran, Johan Wadèn, Lena M. Thorn, Ville-Petteri Mäkinen, Milla Rosengård-Bärlund, Markku Saraheimo, Kustaa Hietala, Outi Heikkilä, and Carol Forsblom, on behalf of the FinnDiane Study Group |
Abstract: | OBJECTIVES This study aimed to identify clinical features associated with premature mortality in a large contemporary cohort of adults with type 1 diabetes. RESEARCH DESIGN AND METHODS The Finnish Diabetic Nephropathy (FinnDiane) study is a national multicenter 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 centers 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 that observed in the age- and sex-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 (standardized mortality ratio [SMR] 0.8, 95% CI 0.5–1.1), independent of the duration of diabetes. The presence of microalbuminuria, macroalbuminuria, and end-stage kidney disease was associated with 2.8, 9.2, and 18.3 times higher SMR, respectively. The increase in mortality across each stage of albuminuria was equivalent to the risk conferred by preexisting 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 chronic kidney disease and its prevention in the management of type 1 diabetes. |
Keywords: | FinnDiane Study Group Humans Diabetic Nephropathies Diabetes Mellitus, Type 1 Insulin Glomerular Filtration Rate Severity of Illness Index Cause of Death Cohort Studies Follow-Up Studies Age of Onset Adolescent Adult Middle Aged Finland Female Male Young Adult |
Rights: | © 2009 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
DOI: | 10.2337/db08-1543 |
Published version: | http://dx.doi.org/10.2337/db08-1543 |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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hdl_84626.pdf | Published version | 322.04 kB | Adobe PDF | View/Open |
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