Risk factors for diabetic kidney disease in adults with longstanding type 1 diabetes: results from the Canadian Study of Longevity in Diabetes. (1st January 2019)

• Record Type: Journal Article
• Authors: Sekercioglu, Nigar; Lovblom, Leif Erik; Bjornstad, Petter; Lovshin, Julie A.; Lytvyn, Yuliya; Boulet, Geneviève; Farooqi, Mohammed A.; Orszag, Andrej; Lai, Vesta; Tse, Josephine; Cham, Leslie; Keenan, Hillary A.; Brent, Michael H.; Paul, Narinder; Bril, Vera; Perkins, Bruce A.; Cherney, David Z. I.
• Is Part Of: Renal failure. Volume 41:Number 1(2019)
• Page Start: 427
• Page End: 433
• Publication Date: 2019-01-01
• Subjects: Type 1 diabetes -- diabetic kidney disease -- diabetic neuropathy -- diabetic retinopathy; Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.1080/0886022X.2019.1614057
• Languages: English
• ISSNs: 0886-022X

Abstract

Abstract: Objectives: Diabetic kidney disease (DKD) is an independent predictor of cardiovascular morbidity and mortality in type 1 diabetes (T1D). We aimed to explore clinical and biochemical factors, including the achievement of American Diabetes Association (ADA) recommended targets associated with DKD in people living with T1D for ≥50 years. Methods: This was a post hoc analysis of a cross-sectional study of 75 participants enrolled in the Canadian Study of Longevity in T1D. We explored diabetes-related complications, including neuropathy, retinopathy, cardiovascular disease, and DKD. Study participants were dichotomized based on the achievement of ADA recommended targets as the low-target group (achieving ≤4 targets, n = 31) and high-target group (achieving >4 targets, n = 44). The outcome of interest was DKD defined by estimated glomerular filtration rate (eGFR) values <60/mL/min/1.73 m 2 and/or 24-h albumin excretion >30 mg. Multivariable logistic regression models were employed to estimate odds ratios (ORs) for DKD with 95% confidence intervals (CIs). Results: Of the 75 participants with prolonged T1D duration (45% male, mean age 66 years), 25 participants had DKD and 50 did not. There was no statistical difference between the high- and low-target groups in terms of age and body mass index. eGFR was significantly higher and the prevalence of diabetic retinopathy was significantly lower in the high-target group. Older age at diagnosis of T1D and lower frequency component to high-frequency component ratio increased the odds of having DKD. Conclusions: In adults with prolonged T1D duration, older age at diagnosis and lower heart rate variability may be associated with DKD.