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Associations between kidney function with all-cause and cause-specific mortality in type 2 diabetes mellitus

Jialiu He1, Ya'nan Wan2, Xikang Fan2

  • 1Department of Epidemiology and Health Statistics, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.

Journal of Health, Population, and Nutrition
|March 14, 2025
PubMed
Summary

Abnormal kidney function in type 2 diabetes mellitus (T2DM) patients is linked to higher mortality. Optimal cut-off values for eGFR, urea, and uric acid can help predict mortality risk in T2DM management.

Keywords:
CancerCardiovascular diseaseKidney functionMortalityType 2 diabetes mellitus

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Area of Science:

  • Nephrology
  • Endocrinology
  • Public Health

Background:

  • Abnormal kidney function is a known risk factor for adverse outcomes in type 2 diabetes mellitus (T2DM).
  • Limited evidence exists on the specific relationship between kidney function markers and mortality among Chinese T2DM patients.

Purpose of the Study:

  • To investigate the association between kidney function indicators (eGFR, urea, uric acid) and all-cause and cause-specific mortality in Chinese T2DM patients.
  • To identify optimal cut-off values for these markers to predict mortality risk.

Main Methods:

  • A cohort study of 19,919 T2DM patients in Jiangsu, China (2013-2014).
  • Baseline measurements of serum estimated glomerular filtration rate (eGFR), urea, and uric acid.
  • Cox regression models and restricted cubic splines to analyze mortality associations and dose-response relationships; ROC curves for optimal cut-off values.

Main Results:

  • During a median 9.77-year follow-up, 4,428 deaths occurred (34.8% CVD, 24.3% cancer).
  • Higher eGFR was associated with lower all-cause and CVD mortality; higher urea and uric acid were linked to increased all-cause mortality (U-shaped relationship).
  • Optimal cut-off values for predicting all-cause mortality were identified: eGFR 88.50 ml/min/1.73m², urea 6.95 mmol/L, and uric acid 342.50 µmol/L.

Conclusions:

  • Abnormal kidney function is significantly associated with increased mortality risk in individuals with T2DM.
  • Further clinical research is needed to validate these findings and refine the use of kidney function markers for T2DM mortality risk assessment and management.