학술논문

Diabetic kidney disease and risk of incident stroke among adults with type 2 diabetes
Document Type
article
Source
BMC Medicine. 20(1)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Brain Disorders
Diabetes
Kidney Disease
Prevention
Clinical Research
Stroke
6.1 Pharmaceuticals
Evaluation of treatments and therapeutic interventions
Metabolic and endocrine
Renal and urogenital
Albuminuria
Diabetes Mellitus
Type 2
Diabetic Nephropathies
Female
Glomerular Filtration Rate
Humans
Male
Middle Aged
Diabetic kidney disease
Epidemiology
Glomerular filtration rate
Type 2 diabetes
Medical and Health Sciences
General & Internal Medicine
Biomedical and clinical sciences
Health sciences
Language
Abstract
BackgroundData on the relations between kidney function abnormalities and stroke in type 2 diabetes are limited. We evaluated the associations of kidney function abnormalities and chronic kidney disease (CKD) stages with incident stroke in a large sample of adults with type 2 diabetes.MethodsParticipants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study without history of stroke at baseline were included. Urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were assessed at baseline. CKD categories were defined according to the KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. Cox proportional hazards regression models were used to compute hazard ratios (HR) and 95% confidence intervals (CI) for stroke in relation to measures of kidney function and CKD categories.ResultsA total of 9170 participants (mean age 62.8 [SD: 6.6] years, 38.2% women, 62.9% white) were included. Over a median follow-up of 4.9 years (interquartile range: 4.0-5.7), 156 participants developed a stroke (incidence rate 3.6/1000 person-years [95% CI 3.0-4.2]). After adjusting for relevant confounders, higher UACR and lower eGFR were each associated with increased risk of stroke. Compared to UACR