Document Detail


Cerebral microvascular disease predicts renal failure in type 2 diabetes.
MedLine Citation:
PMID:  20110380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Abnormalities in small renal vessels may increase the risk of developing impaired renal function, but methods to assess these vessels are extremely limited. We hypothesized that the presence of small vessel disease in the brain, which manifests as silent cerebral infarction (SCI), may predict the progression of kidney disease in patients with type 2 diabetes. We recruited 608 patients with type 2 diabetes without apparent cerebrovascular or cardiovascular disease or overt nephropathy and followed them for a mean of 7.5 years. At baseline, 177 of 608 patients had SCI, diagnosed by cerebral magnetic resonance imaging. The risk for the primary outcome of ESRD or death was significantly higher for patients with SCI than for patients without SCI [hazard ratio, 2.44; 95% confidence interval (CI) 1.36 to 4.38]. The risk for the secondary renal end point of any dialysis or doubling of the serum creatinine concentration was also significantly higher for patients with SCI (hazard ratio, 4.79; 95% CI 2.72 to 8.46). The estimated GFR declined more in patients with SCI than in those without SCI; however, the presence of SCI did not increase the risk for progression of albuminuria. In conclusion, independent of microalbuminuria, cerebral microvascular disease predicted renal morbidity among patients with type 2 diabetes.
Authors:
Takashi Uzu; Yasuo Kida; Nobuo Shirahashi; Tamaki Harada; Atsushi Yamauchi; Makoto Nomura; Keiji Isshiki; Shin-Ichi Araki; Toshiro Sugimoto; Daisuke Koya; Masakazu Haneda; Atsunori Kashiwagi; Ryuichi Kikkawa
Publication Detail:
Type:  Journal Article     Date:  2010-01-28
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  21     ISSN:  1533-3450     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-03-25     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  520-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan. takuzu@belle.shiga-med.ac.jp
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Albuminuria / epidemiology
Cerebrovascular Circulation
Cerebrovascular Disorders / epidemiology*,  pathology
Diabetes Mellitus, Type 2 / epidemiology*,  pathology
Diabetic Nephropathies / epidemiology*
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Incidence
Kaplan-Meier Estimate
Kidney Failure, Chronic / epidemiology*
Magnetic Resonance Angiography
Male
Microvessels / pathology
Middle Aged
Morbidity
Predictive Value of Tests
Proportional Hazards Models
Risk Factors
Comments/Corrections
Comment In:
Nat Rev Nephrol. 2010 May;6(5):250   [PMID:  20440867 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy.
Next Document:  Immune phenotype predicts risk for posttransplantation squamous cell carcinoma.