Incidence and Associations of Chronic Kidney Disease in Community Participants With Diabetes: A 5-Year Prospective Analysis of the EXTEND45 Study.

Sukkar, L; Kang, A; Hockham, C; Young, T; Jun, M; Foote, C; Pecoits-Filho, R; Neuen, B; Rogers, K; Pollock, C; Cass, A; Sullivan, D; Wong, G; Knight, J; Peiris, D; Gallagher, M; Jardine, M; EXTEND45 Study Steering Committee

Incidence and Associations of Chronic Kidney Disease in Community Participants With Diabetes: A 5-Year Prospective Analysis of the EXTEND45 Study.

Sukkar, L Kang, A Hockham, C Young, T Jun, M Foote, C Pecoits-Filho, R Neuen, B Rogers, K

Pollock, C Cass, A Sullivan, D Wong, G Knight, J Peiris, D Gallagher, M Jardine, M EXTEND45 Study Steering Committee

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Publisher:: American Diabetes Association
Publication Type:: Journal Article
Citation:: Diabetes care, 2020, 43, (5), pp. 982-990
Issue Date:: 2020-05

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Field	Value	Language
dc.contributor.author	Sukkar, L
dc.contributor.author	Kang, A
dc.contributor.author	Hockham, C
dc.contributor.author	Young, T
dc.contributor.author	Jun, M
dc.contributor.author	Foote, C
dc.contributor.author	Pecoits-Filho, R
dc.contributor.author	Neuen, B
dc.contributor.author	Rogers, K https://orcid.org/0000-0001-5497-4298
dc.contributor.author	Pollock, C
dc.contributor.author	Cass, A
dc.contributor.author	Sullivan, D
dc.contributor.author	Wong, G
dc.contributor.author	Knight, J
dc.contributor.author	Peiris, D
dc.contributor.author	Gallagher, M
dc.contributor.author	Jardine, M
dc.contributor.author	EXTEND45 Study Steering Committee
dc.date.accessioned	2021-03-11T04:31:33Z
dc.date.available	2020-01-31
dc.date.available	2021-03-11T04:31:33Z
dc.date.issued	2020-05
dc.identifier.citation	Diabetes care, 2020, 43, (5), pp. 982-990
dc.identifier.issn	0149-5992
dc.identifier.issn	1935-5548
dc.identifier.uri	http://hdl.handle.net/10453/147040
dc.description.abstract	<h4>Objective</h4>To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m<sup>2</sup> in people with diabetes.<h4>Research design and methods</h4>We identified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m<sup>2</sup> recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m<sup>2</sup> at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m<sup>2</sup> and multivariable Cox regression to examine factors associated with the study outcome.<h4>Results</h4>Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m<sup>2</sup> over a median follow-up time of 5.7 years (interquartile range, 3.0-5.9 years). The eGFR <60 mL/min/1.73 m<sup>2</sup> incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4-4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27).<h4>Conclusions</h4>In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m<sup>2</sup> was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	American Diabetes Association
dc.relation.ispartof	Diabetes care
dc.relation.isbasedon	10.2337/dc19-1803
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Endocrinology & Metabolism
dc.title	Incidence and Associations of Chronic Kidney Disease in Community Participants With Diabetes: A 5-Year Prospective Analysis of the EXTEND45 Study.
dc.type	Journal Article
utslib.citation.volume	43
utslib.location.activity	United States
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2021-03-11T04:31:31Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	43
utslib.citation.issue	5

Abstract:

Objective

To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² in people with diabetes.

Research design and methods

We identified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m² recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m² at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m² and multivariable Cox regression to examine factors associated with the study outcome.

Results

Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m² over a median follow-up time of 5.7 years (interquartile range, 3.0-5.9 years). The eGFR <60 mL/min/1.73 m² incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4-4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27).

Conclusions

In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m² was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence.

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http://hdl.handle.net/10453/147040