TY - JOUR
T1 - Ten years trajectories of estimated glomerular filtration rate (eGFR) in a multiethnic cohort of people with type 1 diabetes and preserved renal function
AU - Ayis, Salma
AU - Mangelis, Anastasios
AU - Fountoulakis, Nikolaos
AU - Collins, Julian
AU - Alobaid, Thamer s
AU - Gnudi, Luigi
AU - Hopkins, David
AU - Vas, Prashanth
AU - Thomas, Stephen
AU - Goubar, Aicha
AU - Karalliedde, Janaka
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.
PY - 2024/9/16
Y1 - 2024/9/16
N2 - Objectives We aim to evaluate estimated glomerular filtration rate (eGFR) patterns of progression in a multiethnic cohort of people with type I diabetes mellitus and with baseline eGFR ≥45 mL/min/1.73 m
2. Design Observational cohort. Setting People with a clinical diagnosis of type 1 diabetes, attending two university hospital-based outpatient diabetes clinics, in South London between 2004 and 2018. Participants We studied 1495 participants (52% females, 81% white, 12% African-Caribbean and 7% others). Primary and secondary outcome measures Clinical measures including weight and height, systolic blood pressure, diastolic blood pressure and laboratory results (such as serum creatinine, urine albumin to creatinine ratio (ACR), HbA1c were collected from electronic health records (EHRs) and eGFR was estimated by the Chronic Kidney Disease–Epidemiology Collaboration. Ethnicity was self-reported. Results Five predominantly linear patterns/groups of eGFR trajectories were identified. Group I (8.5%) had a fast eGFR decline (>3 mL/min/1.73 m
2 year). Group II (23%) stable eGFR, group III (29.8%), groups IV (26.3%) and V (12.4%) have preserved eGFR with no significant fall. Group I had the highest proportion (27.6%) of African-Caribbeans. Significant differences between group I and the other groups were observed in age, gender, HbA1C, systolic and diastolic blood pressure, body mass index, cholesterol and urine ACR, p<0.05 for all. At 10 years of follow-up, 33% of group I had eGFR <30 and 16.5%<15 (mL/min/1.73 m
2). Conclusions Distinct trajectories of eGFR were observed in people with type 1 diabetes. The group with the highest risk of eGFR decline had a greater proportion of African-Caribbeans compared with others and has higher prevalence of traditional modifiable risk factors for kidney disease.
AB - Objectives We aim to evaluate estimated glomerular filtration rate (eGFR) patterns of progression in a multiethnic cohort of people with type I diabetes mellitus and with baseline eGFR ≥45 mL/min/1.73 m
2. Design Observational cohort. Setting People with a clinical diagnosis of type 1 diabetes, attending two university hospital-based outpatient diabetes clinics, in South London between 2004 and 2018. Participants We studied 1495 participants (52% females, 81% white, 12% African-Caribbean and 7% others). Primary and secondary outcome measures Clinical measures including weight and height, systolic blood pressure, diastolic blood pressure and laboratory results (such as serum creatinine, urine albumin to creatinine ratio (ACR), HbA1c were collected from electronic health records (EHRs) and eGFR was estimated by the Chronic Kidney Disease–Epidemiology Collaboration. Ethnicity was self-reported. Results Five predominantly linear patterns/groups of eGFR trajectories were identified. Group I (8.5%) had a fast eGFR decline (>3 mL/min/1.73 m
2 year). Group II (23%) stable eGFR, group III (29.8%), groups IV (26.3%) and V (12.4%) have preserved eGFR with no significant fall. Group I had the highest proportion (27.6%) of African-Caribbeans. Significant differences between group I and the other groups were observed in age, gender, HbA1C, systolic and diastolic blood pressure, body mass index, cholesterol and urine ACR, p<0.05 for all. At 10 years of follow-up, 33% of group I had eGFR <30 and 16.5%<15 (mL/min/1.73 m
2). Conclusions Distinct trajectories of eGFR were observed in people with type 1 diabetes. The group with the highest risk of eGFR decline had a greater proportion of African-Caribbeans compared with others and has higher prevalence of traditional modifiable risk factors for kidney disease.
KW - Diabetes type 2 , nephropathy , eGFR , Trajectory
UR - http://www.scopus.com/inward/record.url?scp=85204078235&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-083186
DO - 10.1136/bmjopen-2023-083186
M3 - Article
SN - 2044-6055
VL - 14
SP - e083186
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e083186
ER -
