Association of hyperglycemic crisis with an increased risk of end-stage renal disease: A nationwide population-based cohort study

作者：Kao Yuan; Feng I Jung; Hsu Chien Chin; Wang Jhi Joung; Lin Hung Jung; Huang Chien Cheng

来源：Diabetes Research and Clinical Practice, 2018, 138: 106-112.

DOI：10.1016/j.diabres.2018.01.008

• Diabetes
• End-stage renal disease
• Hyperglycemic crisis

Background: A hyperglycemic crisis episode (HCE) is associated with poor management of diabetes, which is a risk factor for end-stage renal disease (ESRD); however, the association between an HCE and ESRD has not been clarified. We conducted a nationwide population-based cohort study with the purpose of delineating this issue.
Methods: We identified 9208 diabetic patients with an HCE and an identical number of diabetic patients with matched age, sex, and index date without an HCE between 2000 and 2002. A comparison of the risk of ESRD between the diabetic patients with and without an HCE was achieved by a follow-up until 2014.
Results: A Cox proportional hazard regression analysis showed that the diabetic patients with an HCE were at a higher risk of ESRD than those without an HCE (the adjusted hazard ratio [AHR]: 1.47; 95% confidence interval [CI]: 1.34-1.62) by adjusting for renal disease, hypertension, hyperlipidemia, coronary artery disease, hyperuricemia, anemia, chronic obstructive pulmonary disease, liver disease, malignancy, connective tissue disease, nonsteroid anti-inflammatory drug use, and monthly income. The increased risk of ESRD was more prominent in the age subgroup of 15-25 years (AHR: 4.91; 95% CI: 1.92-12.56); 25-35 years (AHR: 2.42; 95% CI: 1.51-3.86); 35-45 years (AHR: 3.01; 95% CI: 2.21-4.09); and 45-55 years (AHR: 1.75; 95% CI: 1.41-2.19).
Conclusions: An HCE was associated with an increased risk of ESRD, especially in the younger diabetic patients (15-55 years). A close follow-up for the control of diabetes and for monitoring renal function is proposed.

• 出版日期2018-4
• 单位河北医科大学