| Literature DB >> 35043149 |
Guozhi Jiang1,2,3, Andrea O Luk2,3,4, Claudia H T Tam2,3,4,5, Risa Ozaki2,3, Cadmon K P Lim2,4,5, Elaine Y K Chow2,3, Eric S Lau5, Alice P S Kong2,3,4, Baoqi Fan2,3,4,5, Ka Fai Lee6, Shing Chung Siu7, Grace Hiu7, Chiu Chi Tsang8, Kam Piu Lau9, Jenny Y Leung10, Man-wo Tsang11, Grace Kam11, Ip Tim Lau12, June K Li13, Vincent T Yeung14, Emmy Lau15, Stanley Lo15, Samuel Fung16, Yuk Lun Cheng17, Chun Chung Chow2, Nelson L S Tang18, Yu Huang19, Hui-yao Lan2,4, Richard A Oram20, Cheuk Chun Szeto2,4, Wing Yee So2,3, Juliana C N Chan2,3,4,5, Ronald C W Ma2,3,4,5.
Abstract
We aim to assess the long-term impact of acute kidney injury (AKI) on progression of diabetic kidney disease (DKD) and all-cause mortality and investigate determinants of AKI in Chinese patients with type 2 diabetes (T2D). A consecutive cohort of 9,096 Chinese patients with T2D from the Hong Kong Diabetes Register was followed for 12 years (mean ± SD age 57 ± 13.2 years; 46.9% men; median duration of diabetes 5 years). AKI was defined based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria using serum creatinine. Estimated glomerular filtration rate measurements were used to identify the first episode with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Polygenic risk score (PRS) composed of 27 single nucleotide polymorphisms (SNPs) known to be associated with serum uric acid (SUA) in European populations was used to examine the role of SUA in pathogenesis of AKI, CKD, and ESRD. Validation was sought in an independent cohort including 6,007 patients (age 61.2 ± 10.9 years; 59.5% men; median duration of diabetes 10 years). Patients with AKI had a higher risk for developing incident CKD (hazard ratio 14.3 [95% CI 12.69-16.11]), for developing ESRD (12.1 [10.74-13.62]), and for all-cause death (7.99 [7.31-8.74]) compared with those without AKI. Incidence rate for ESRD among patients with no episodes of AKI and one, two, and three or more episodes of AKI was 7.1, 24.4, 32.4, and 37.3 per 1,000 person-years, respectively. Baseline SUA was a strong independent predictor for AKI. A PRS composed of 27 SUA-related SNPs was associated with AKI and CKD in both discovery and replication cohorts but not ESRD. Elevated SUA may increase the risk of DKD through increasing AKI. The identification of SUA as a modifiable risk factor and PRS as a nonmodifiable risk factor may facilitate the identification of individuals at high risk to prevent AKI and its long-term impact in T2D.Entities:
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Year: 2022 PMID： 35043149 PMCID： PMC8893937 DOI： 10.2337/db21-0694
Source DB: PubMed Journal: Diabetes ISSN： 0012-1797 Impact factor: 9.461