Abstract | OBJECTIVE: RESEARCH DESIGN AND METHODS: Patients with diabetes in CKD stages 1-3 were selected from three cohorts: two from Joslin Diabetes Center, one with type 1 diabetes (N = 364) and one with type 2 diabetes (N = 402), and the third from the Finnish Diabetic Nephropathy (FinnDiane) Study of type 1 (N = 399). Baseline serum concentrations of creatinine and cystatin C were measured in all patients. Follow-up averaged 8-10 years and onsets of ESRD (n = 246) and death unrelated to ESRD (n = 159) were ascertained. RESULTS: Although CKD staging by eGFRcyst was concordant with that by eGFRcreat for 62% of Joslin patients and 73% of FinnDiane patients, those given a higher stage by eGFRcyst than eGFRcreat had a significantly higher risk of ESRD than those with concordant staging in all three cohorts (hazard ratio 2.3 [95% CI 1.8-3.1]). Similarly, patients at a lower stage by eGFRcyst than by eGFRcreat had a lower risk than those with concordant staging (0.30 [0.13-0.68]). Deaths unrelated to ESRD followed the same pattern, but differences were not as large. CONCLUSIONS: In patients with diabetes, CKD staging based on eGFRcyst significantly improves ESRD risk stratification based on eGFRcreat. This conclusion can be generalized to patients with type 1 and type 2 diabetes and to diabetic patients in the U.S. and Finland.
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Authors | Andrzej S Krolewski, James H Warram, Carol Forsblom, Adam M Smiles, Lena Thorn, Jan Skupien, Valma Harjutsalo, Robert Stanton, John H Eckfeldt, Lesley A Inker, Per-Henrik Groop |
Journal | Diabetes care
(Diabetes Care)
Vol. 35
Issue 11
Pg. 2311-6
(Nov 2012)
ISSN: 1935-5548 [Electronic] United States |
PMID | 22851596
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adolescent
- Adult
- Child
- Child, Preschool
- Creatinine
(blood)
- Cystatin C
(blood)
- Diabetic Nephropathies
(blood, epidemiology)
- Female
- Glomerular Filtration Rate
- Humans
- Kidney Failure, Chronic
(blood, epidemiology)
- Male
- Young Adult
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