PMID- 33741351
OWN - NLM
STAT- MEDLINE
DCOM- 20210517
LR  - 20210517
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 174
DP  - 2021 Apr
TI  - Association of overhydration and serum pigment epithelium-derived factor with CKD 
      progression in diabetic kidney disease: A prospective cohort study.
PG  - 108754
LID - S0168-8227(21)00107-8 [pii]
LID - 10.1016/j.diabres.2021.108754 [doi]
AB  - AIM: Little is known about whether overhydration (OH), measured using 
      bioimpedance assay (BIA), is associated with CKD progression in patients with 
      type 2 diabetes mellitus (T2DM). We hypothesised that OH was a predictor, and 
      pigment epithelium-derived factor (PEDF) was a modifiable risk factor of CKD 
      progression. METHODS: We conducted a prospective cohort study of 1,065 patients 
      with clinically euvolemic T2DM who attended the diabetes centre in a tertiary 
      hospital or primary care clinic. CKD progression was defined as a combination of 
      the worsening of the KDIGO defined CKD category by eGFR and a >/=25% decline in 
      eGFR compared to baseline. RESULTS: Patients with T2DM in the highest tertile of 
      OH and relative OH (OH/ extracellular water > 7%) were positively associated with 
      CKD progression (hazard ratio [HR] 1.45 [95% confidence interval (CI) 1.14-1.85; 
      p = 0.003 and HR 1.29 [95%CI 1.05-1.59; p = 0.017]). There were positive 
      associations between PEDF and CKD progression (beta = 1.10; p = 0.001) and between 
      OH and CKD progression (beta = 0.21; p = 0.036). OH remained positively associated 
      with CKD progression mediated by PEDF. CONCLUSIONS: OH is an independent risk 
      factor for CKD progression in patients with T2DM. Our study supports the novel 
      definition of PEDF as a positive mediator between OH and CKD progression.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Liu, Allen Yan Lun
AU  - Liu AYL
AD  - Department of General Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, 
      Singapore.
FAU - Pek, Sharon
AU  - Pek S
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 
      768828, Singapore.
FAU - Low, Serena
AU  - Low S
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 
      768828, Singapore.
FAU - Moh, Angela
AU  - Moh A
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 
      768828, Singapore.
FAU - Ang, Keven
AU  - Ang K
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 
      768828, Singapore.
FAU - Tang, Wern Ee
AU  - Tang WE
AD  - National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, 
      South Tower, Singapore 138543, Singapore.
FAU - Lim, Ziliang
AU  - Lim Z
AD  - National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, 
      South Tower, Singapore 138543, Singapore.
FAU - Subramaniam, Tavintharan
AU  - Subramaniam T
AD  - Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, Kampung Admiralty, 
      Woodlands Drive 71, Singapore 730676, Singapore.
FAU - Sum, Chee Fang
AU  - Sum CF
AD  - Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, Kampung Admiralty, 
      Woodlands Drive 71, Singapore 730676, Singapore.
FAU - Lim, Su Chi
AU  - Lim SC
AD  - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 
      768828, Singapore; Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, 
      Kampung Admiralty, Woodlands Drive 71, Singapore 730676, Singapore; Saw Swee Hock 
      School of Public Health, National University of Singapore, 12 Science Drive 2, 
      #10-01, Singapore 117549, Singapore. Electronic address: lim.su.chi@ktph.com.sg.
LA  - eng
PT  - Journal Article
DEP - 20210317
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Eye Proteins)
RN  - 0 (Nerve Growth Factors)
RN  - 0 (Serpins)
RN  - 0 (pigment epithelium-derived factor)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*physiopathology
MH  - Diabetic Nephropathies/*complications
MH  - Disease Progression
MH  - Eye Proteins/*blood
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Humans
MH  - Kidney Failure, Chronic/blood/etiology/*pathology
MH  - Male
MH  - Middle Aged
MH  - Nerve Growth Factors/*blood
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Serpins/*blood
MH  - Survival Rate
MH  - Water-Electrolyte Imbalance/*complications
OTO - NOTNLM
OT  - Albuminuria
OT  - Body composition
OT  - Chronic kidney disease
OT  - Type 2 diabetes
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2021/03/21 06:00
MHDA- 2021/05/18 06:00
CRDT- 2021/03/20 05:58
PHST- 2020/12/22 00:00 [received]
PHST- 2021/03/03 00:00 [revised]
PHST- 2021/03/07 00:00 [accepted]
PHST- 2021/03/21 06:00 [pubmed]
PHST- 2021/05/18 06:00 [medline]
PHST- 2021/03/20 05:58 [entrez]
AID - S0168-8227(21)00107-8 [pii]
AID - 10.1016/j.diabres.2021.108754 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2021 Apr;174:108754. doi: 10.1016/j.diabres.2021.108754. 
      Epub 2021 Mar 17.