使用KDIGO分类的1型糖尿病患者的负担和不良结果的过度风险:国家队列研究
Kianoush Makvandi1,2, Björn Eliasson1,3, Hanne Krage Carlsen3
1Department of Molecular and Clinical Medicine, The Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Diabetes care
|November 20, 2024
概括
病:改善全球结果 (KDIGO) 分类显示,1型糖尿病患者的不良结果风险增加. 即使没有慢性病 (CKD) 的人也面临高风险,强调需要更密切的监测.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
背景情况:
- 病:改善全球结果 (KDIGO) 分类被广泛使用,但其在1型糖尿病中对风险分层的有用性需要进一步调查.
- 在1型糖尿病中评估与KDIGO类别相关的不良结果的全谱对于积极的患者管理至关重要.
研究的目的:
- 评估KDIGO分类类别与1型糖尿病患者不良脏和心血管结果的风险之间的相关性.
- 确定不同类型的KDIGO的流行率和每个类别内的不良事件发生率.
主要方法:
- 瑞典国家糖尿病登记处的一项观察性研究,涉及40199名1型糖尿病患者.
- 考克斯回归分析用于评估基线KDIGO类别和结果之间的关联,包括eGFR下降,功能衰竭,主要不良/心血管事件和全因死亡率.
主要成果:
- 在39,067名参与者中,18.5%患有慢性病 (CKD).
- 随着KDIGO类别的推进,观察到不良结果和调整后的危险比率的逐步增加,包括G2A1 (非CKD) 组.
- 增加估计的淋巴膜过率 (eGFR) ≥105毫升/分钟/1.73平方米,没有白色素尿,没有显示增加风险.
结论:
- 在1型糖尿病中,随着KDIGO分类类别的更高,不良结果负担逐渐增加.
- 被归类为G2A1 (正常蛋白尿,保存EGFR) 的个体,通常被认为不是CKD,对所有研究的不良结果都表现出过度风险.
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