PMID- 30177484
OWN - NLM
STAT- MEDLINE
DCOM- 20191226
LR  - 20240420
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Print)
IS  - 0272-6386 (Linking)
VI  - 73
IP  - 1
DP  - 2019 Jan
TI  - Incident Type 2 Diabetes Among Individuals With CKD: Findings From the Chronic 
      Renal Insufficiency Cohort (CRIC) Study.
PG  - 72-81
LID - S0272-6386(18)30823-0 [pii]
LID - 10.1053/j.ajkd.2018.06.017 [doi]
AB  - RATIONALE & OBJECTIVE: Few studies have examined incident type 2 diabetes 
      mellitus (T2DM) in chronic kidney disease (CKD). Our objective was to examine 
      rates of and risk factors for T2DM in CKD, using several alternative measures of 
      glycemic control. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 
      1,713 participants with reduced glomerular filtration rates and without diabetes 
      at baseline, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. 
      PREDICTORS: Measures of kidney function and damage, fasting blood glucose, 
      hemoglobin A(1c) (HbA(1c)), HOMA-IR (homeostatic model assessment of insulin 
      resistance), demographics, family history of diabetes mellitus (DM), smoking 
      status, medication use, systolic blood pressure, triglyceride level, high-density 
      lipoprotein cholesterol level, body mass index, and physical activity. OUTCOME: 
      Incident T2DM (defined as fasting blood glucose >/= 126mg/dL or prescription of 
      insulin or oral hypoglycemic agents). ANALYTICAL APPROACH: Concordance between 
      fasting blood glucose and HbA(1c) levels was assessed using kappa. Cause-specific 
      hazards modeling, treating death and end-stage kidney disease as competing 
      events, was used to predict incident T2DM. RESULTS: Overall T2DM incidence rate 
      was 17.81 cases/1,000 person-years. Concordance between fasting blood glucose and 
      HbA(1c) levels was low (kappa for categorical versions of fasting blood glucose and 
      HbA(1c) = 13%). Unadjusted associations of measures of kidney function and damage 
      with incident T2DM were nonsignificant (P >/= 0.4). In multivariable models, T2DM 
      was significantly associated with fasting blood glucose level (P = 0.002) and 
      family history of DM (P = 0.03). The adjusted association of HOMA-IR with T2DM 
      was comparable to that of fasting blood glucose level; the association of HbA(1c) 
      level was nonsignificant (P >/= 0.1). Harrell's C for the models ranged from 0.62 
      to 0.68. LIMITATIONS: Limited number of outcome events; predictors limited to 
      measures taken at baseline. CONCLUSIONS: The T2DM incidence rate among 
      individuals with CKD is markedly higher than in the general population, 
      supporting the need for greater vigilance in this population. Measures of 
      glycemic control and family history of DM were independently associated with 
      incident T2DM.
CI  - Copyright (c) 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Jepson, Christopher
AU  - Jepson C
AD  - Department of Biostatistics, Epidemiology and Informatics, Perelman School of 
      Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical 
      Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA. 
      Electronic address: cjepson@pennmedicine.upenn.edu.
FAU - Hsu, Jesse Y
AU  - Hsu JY
AD  - Department of Biostatistics, Epidemiology and Informatics, Perelman School of 
      Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical 
      Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA.
FAU - Fischer, Michael J
AU  - Fischer MJ
AD  - Department of Medicine, University of Illinois College of Medicine, Chicago, IL; 
      Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr VA Hospital, 
      Hines, and Jesse Brown VAMC, Chicago, IL.
FAU - Kusek, John W
AU  - Kusek JW
AD  - Division of Kidney, Urologic and Hematologic Diseases, National Institute of 
      Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 
      Bethesda, MD.
FAU - Lash, James P
AU  - Lash JP
AD  - Department of Medicine, University of Illinois College of Medicine, Chicago, IL.
FAU - Ricardo, Ana C
AU  - Ricardo AC
AD  - Department of Medicine, University of Illinois College of Medicine, Chicago, IL.
FAU - Schelling, Jeffrey R
AU  - Schelling JR
AD  - Division of Nephrology and Hypertension, Case Western Reserve University, 
      Cleveland, OH.
FAU - Feldman, Harold I
AU  - Feldman HI
AD  - Department of Biostatistics, Epidemiology and Informatics, Perelman School of 
      Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical 
      Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA.
CN  - Chronic Renal Insufficiency Cohort (CRIC) Study Investigators
LA  - eng
GR  - R01 DK072231/DK/NIDDK NIH HHS/United States
GR  - U01 DK060963/DK/NIDDK NIH HHS/United States
GR  - UL1 RR024131/RR/NCRR NIH HHS/United States
GR  - U01 DK061022/DK/NIDDK NIH HHS/United States
GR  - UL1 TR000003/TR/NCATS NIH HHS/United States
GR  - UL1 TR000439/TR/NCATS NIH HHS/United States
GR  - U01 DK060990/DK/NIDDK NIH HHS/United States
GR  - K23 DK094829/DK/NIDDK NIH HHS/United States
GR  - UL1 RR029879/RR/NCRR NIH HHS/United States
GR  - U01 DK061028/DK/NIDDK NIH HHS/United States
GR  - UL1 TR000433/TR/NCATS NIH HHS/United States
GR  - U01 DK060984/DK/NIDDK NIH HHS/United States
GR  - U01 DK061021/DK/NIDDK NIH HHS/United States
GR  - U24 DK060990/DK/NIDDK NIH HHS/United States
GR  - U01 DK060980/DK/NIDDK NIH HHS/United States
GR  - UL1 TR000424/TR/NCATS NIH HHS/United States
GR  - M01 RR016500/RR/NCRR NIH HHS/United States
GR  - P20 GM109036/GM/NIGMS NIH HHS/United States
GR  - U01 DK060902/DK/NIDDK NIH HHS/United States
GR  - UL1 TR002003/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20180901
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/*complications/*epidemiology
MH  - Diabetic Nephropathies/*complications/*epidemiology
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Renal Insufficiency, Chronic/*complications
MH  - Risk Factors
PMC - PMC6309655
MID - NIHMS1501636
OTO - NOTNLM
OT  - Diabetes
OT  - chronic kidney disease (CKD)
OT  - chronic kidney insufficiency
OT  - fasting blood sugar (FBS)
OT  - glycemic control
OT  - hemoglobin A(1c) (HbA(1c))
OT  - insulin resistance (HOMA-IR)
OT  - kidney function
OT  - prediabetes
OT  - renal damage
OT  - type 2 diabetes mellitus (T2DM)
FIR - Appel, Lawrence J
IR  - Appel LJ
FIR - Feldman, Harold I
IR  - Feldman HI
FIR - Go, Alan S
IR  - Go AS
FIR - He, Jiang
IR  - He J
FIR - Kusek, John W
IR  - Kusek JW
FIR - Lash, James P
IR  - Lash JP
FIR - Ojo, Akinlolu
IR  - Ojo A
FIR - Rahman, Mahboob
IR  - Rahman M
FIR - Townsend, Raymond R
IR  - Townsend RR
EDAT- 2018/09/05 06:00
MHDA- 2019/12/27 06:00
PMCR- 2020/01/01
CRDT- 2018/09/05 06:00
PHST- 2018/01/22 00:00 [received]
PHST- 2018/06/12 00:00 [accepted]
PHST- 2018/09/05 06:00 [pubmed]
PHST- 2019/12/27 06:00 [medline]
PHST- 2018/09/05 06:00 [entrez]
PHST- 2020/01/01 00:00 [pmc-release]
AID - S0272-6386(18)30823-0 [pii]
AID - 10.1053/j.ajkd.2018.06.017 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2019 Jan;73(1):72-81. doi: 10.1053/j.ajkd.2018.06.017. Epub 2018 
      Sep 1.