Renal disease progression and associated factors in type 2 diabetes patients: A retrospective cohort study
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Abstract
Predicting renal disease progression in patients with diabetes is an important clinical and policy challenge. This study aimed to investigate the survival function of renal disease progression by assessing the doubling of serum creatinine (DSC) over time and the factors associated with DSC in patients with type 2 diabetes mellitus (T2DM). This retrospective cohort study included 3,465 T2DM patients from a tertiary hospital in Thailand. Patients’ data from 2011 to 2017 were extracted from the electronic medical records. The Kaplan-Meier method and Cox’s proportional hazard model were analyzed to determine the survival time of T2DM patients with DSC and the factors associated with DSC. Results showed that at the end of the follow-up period, 1,028 of 3,465 patients underwent DSC. The incidence rate of DSC was 5.0/1,000 person-months. The median survival time of DSC was 81.5 months (95% confidence interval [CI]: 79.28 – 83.74). The variables associated with an increased hazard ratio of DSC were high triglyceride level (≥200 mg/dl) (adjusted hazard ratio (aHR): 1.17, 95% CI: 1.01 – 1.34), hypertension (aHR: 1.33, 95% CI: 1.18 – 1.51), high glycated hemoglobin level (≥7.0%) (aHR: 1.27, 95% CI: 1.07–1.51), and high total cholesterol level (≥ 240 mg/dl) (aHR: 1.58, 95% CI: 1.32 – 1.87). Obesity (BMI of ≥ 25.0 kg/m2) was negatively associated with DSC (aHR: 0.80, 95% CI: 0.71 – 0.91). In conclusion, T2DM patients under observation had a median survival time of DSC of 6.8 years. Hypertension and uncontrolled blood glucose and lipids are predictors of renal disease progression in T2DM patients.
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