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Risk of acute renal failure in patients with Type 2 diabetes mellitus.
MedLine Citation:
PMID:  22017349     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims:  Progressive decline in renal function has been well-described in patients with Type 2 diabetes mellitus, but few studies have assessed the risk of acute renal failure in a large population of patients with Type 2 diabetes. This study quantified the risk of acute renal failure associated with Type 2 diabetes in the General Practice Research Database from the UK. Methods:  Patients with Type 2 diabetes (n = 119 966) and patients without diabetes (n = 1 794 516) were identified in the General Practice Research Database. Patients with end-stage renal disease were excluded. Crude incidence and multivariate-adjusted hazard ratios of acute renal failure were estimated for patients with Type 2 diabetes relative to those without diabetes. Cox regression models were adjusted for a variety of co-morbidities. Increase of acute renal failure risk resulting from additive effects of specific co-morbidities with Type 2 diabetes was also assessed. Results:  Between 2003 and 2007, acute renal failure incidence was 198 per 100 000 person-years in patients with Type 2 diabetes compared with 27 per 100 000 patients-years among patients without Type 2 diabetes (crude hazard ratio 8.0, 95% CI 7.4-8.7). Risk of acute renal failure for patients with Type 2 diabetes remained significant, but was attenuated in multivariate analyses adjusting for various co-morbidities (adjusted hazard ratio 2.5, 95% CI 2.2-2.7). Age and specific co-morbidities (chronic kidney disease, hypertension and congestive heart failure) were also associated with increased risk of acute renal failure in Type 2 diabetes. Conclusions:  Patients with Type 2 diabetes have increased risk for acute renal failure compared with patients without diabetes, even after adjustment for known risk factors, particularly in the elderly and those with other co-morbidities such as chronic kidney disease, congestive heart failure and hypertension.
Authors:
C J Girman; T D Kou; K Brodovicz; C M Alexander; E A O'Neill; S Engel; D E Williams-Herman; L Katz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-20
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  -     ISSN:  1464-5491     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Journal compilation © 2011 Diabetes UK.
Affiliation:
Merck Sharp & Dohme Corp., Whitehouse Station, NJ Amgen Inc., Thousand Oaks, CA, USA.
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