Among individuals with both diabetes and kidney disease, standardized mortality was 31.1% (95% CI, 24.7%–37.5%), representing an absolute risk difference with the reference group of 23.4% (95% CI, 17.0%–29.9%), adjusted for demographics, and 23.4% (95% CI, 17.2%–29.6%) when further adjusted. We observed similar patterns for cardiovascular and noncardiovascular mortality. In conclusion, those with kidney disease predominantly account for the increased mortality observed in type 2 diabetes.
A Mustang High School student is recovering from kidney failure after smoking synthetic marijuana. He is one of two patients in an Oklahoma City hospital with kidney failure because of synthetic marijuana.
In a large cohort study, relative mortality risk for reduced eGFR was higher in every age category, but fell with increasing age (P<0.05), with similar albeit less evident findings for increased albuminuria, Josef Coresh, MD, PhD, of the Chronic Kidney Disease Prognosis Consortium Data Coordinating Center in Baltimore, and colleagues reported online in the Journal of the American Medical Association.
Overall, Coresh and colleagues found that death and ESRD risks were higher at lower eGFR and higher albuminuria in every age category.
Conclusions: Sleep apnea is common in patients with CKD and increases as kidney function declines. Almost 50% of patients with CKD and ESRD experience nocturnal hypoxia, which may contribute to loss of kidney function and increased cardiovascular risk.
In a large cohort study, patients with only CKD had a significantly higher rate of myocardial infarction (MI) than those who only had diabetes (5.4 versus 6.9 per 1,000 person-years, P
Those who’d already had an MI had the highest overall rate of MI (18.5 per 1,000 person-years), they reported online in The Lancet.
This meta-analysis found that the presence of chronic kidney disease strongly predicted mortality risk in patients with type 2 diabetes. Chronic kidney disease more than doubles mortality risk in patients with type 2 diabetes, researchers found. In an analysis of nearly two dozen randomized controlled trials involving diabetic patients, the highest mortality rates were observed in those trials that required the inclusion of patients with renal disease, according to Marc Pfeffer, MD, PhD, of Brigham and Women’s Hospital in Boston, and colleagues. Trials that selected for patients with elevated serum creatinine or impaired estimated glomerular filtration rate eGFR had mortality rates of 5.9 to 8.2 per 100 patient-years, whereas the rest of the trials had rates no higher than 3.3, the researchers reported online in the Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease.
Patients with chronic kidney disease had a significantly increased risk of death after myocardial infarction, and the risk increased as glomerular filtration rate (GFR) declined, a review of 103,000 myocardial infarction patients showed.
The excess mortality risk ranged from 17% to as much as 500% as the severity of chronic kidney disease (CKD) increased. CKD predicted heightened mortality regardless of the presence or absence of ST-segment elevation.
Watch that GFR.
The study showed that measuring albumin:creatinine ratio from a first-void urine sample is more accurate for predicting progression of kidney disease in type 2 diabetics than are other commonly used measures.