Featured Research

from universities, journals, and other organizations

Competing risks analysis highlights new targets in preventing ESRD and death of diabetics

Date:
February 18, 2011
Source:
University of Helsinki
Summary:
Many patients with Type 1 diabetes and overt nephropathy develop End-Stage Renal Disease (ESRD) and/or succumb to a premature death. The competing risks of death and ESRD may confound the estimates of risk for each outcome. Now, the researchers have determined the major predictors of the cumulative incidence of ESRD and pre-ESRD mortality in patients with Type 1 diabetes and macroalbuminuria while incorporating the competing risk for the alternate outcome into a Fine-Gray competing-risks analysis.

Patients with both type 1 diabetes and CKD have an increased risk of adverse outcomes. Despite aggressive treatment, many patients with type 1 diabetes and overt nephropathy develop End-Stage Renal Disease (ESRD) and/or succumb to a premature death. The competing risks of death and ESRD may confound the estimates of risk for each outcome.

Related Articles


Now, the researchers at the University of Helsinki, University Hospital of Helsinki and Folkhälsan Research Center, Finland, and at the Queen Elisabeth Hospital and Baker IDI Heart and Diabetes Institute, Australia, have determined the major predictors of the cumulative incidence of ESRD and pre-ESRD mortality in patients with type 1 diabetes and macroalbuminuria while incorporating the competing risk for the alternate outcome into a Fine-Gray competing-risks analysis. This research is appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN).

The researchers followed 592 patients with macroalbuminuria for a median of 9.9 years. During this time, 56 (9.5%) patients died and 210 (35.5%) patients developed ESRD. Predictors of incident ESRD, taking baseline renal function and the competing risk for death into account, included an elevated HbA1c, elevated LDL cholesterol, male sex, weight-adjusted insulin dose, and a shorter duration of diabetes. By contrast, predictors of pre-ESRD death, taking baseline renal function and the competing risk for ESRD into account, included only age, the presence of established macrovascular disease, and elevated cholesterol levels.

"In our cohort, ESRD was the most likely outcome, potentially driving epidemiologic associations between risk factors and all-cause mortality. By adjusting for these competing risks, we show that poor glycemic control increases the cumulative incidence of ESRD, but is not associated with increased pre-ESRD mortality. By contrast, improved lipid control may affect both ESRD outcomes and pre-ESRD mortality," says Dr. Carol Forsblom from the University of Helsinki and Folkhälsan Research Center.

"This kind of novel statistical approach has the potential to shed new light on the targets and strategies for preventing premature mortality in patients with type 1 diabetes," Dr. Forsblom states.


Story Source:

The above story is based on materials provided by University of Helsinki. Note: Materials may be edited for content and length.


Journal Reference:

  1. Carol Forsblom, Valma Harjutsalo, Lena M. Thorn, Johan Wadén, Nina Tolonen, Markku Saraheimo, Daniel Gordin, John L. Moran, Merlin C. Thomas, Per-Henrik Groop. Competing-Risk Analysis of ESRD and Death among Patients with Type 1 Diabetes and Macroalbuminuria. Journal of the American Society Nephrology, 2011; DOI: 10.1681/ASN.2010020194

Cite This Page:

University of Helsinki. "Competing risks analysis highlights new targets in preventing ESRD and death of diabetics." ScienceDaily. ScienceDaily, 18 February 2011. <www.sciencedaily.com/releases/2011/02/110218083432.htm>.
University of Helsinki. (2011, February 18). Competing risks analysis highlights new targets in preventing ESRD and death of diabetics. ScienceDaily. Retrieved April 18, 2015 from www.sciencedaily.com/releases/2011/02/110218083432.htm
University of Helsinki. "Competing risks analysis highlights new targets in preventing ESRD and death of diabetics." ScienceDaily. www.sciencedaily.com/releases/2011/02/110218083432.htm (accessed April 18, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, April 18, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Our Love Of Puppy Dog Eyes Explained By Science

Our Love Of Puppy Dog Eyes Explained By Science

Newsy (Apr. 17, 2015) — Researchers found a spike in oxytocin occurs in both humans and dogs when they gaze into each other&apos;s eyes. Video provided by Newsy
Powered by NewsLook.com
Scientists Find Link Between Gestational Diabetes And Autism

Scientists Find Link Between Gestational Diabetes And Autism

Newsy (Apr. 17, 2015) — Researchers who analyzed data from over 300,000 kids and their mothers say they&apos;ve found a link between gestational diabetes and autism. Video provided by Newsy
Powered by NewsLook.com
Video Messages Help Reassure Dementia Patients

Video Messages Help Reassure Dementia Patients

AP (Apr. 17, 2015) — Family members are prerecording messages as part of a unique pilot program at the Hebrew Home in New York. The videos are trying to help victims of Alzheimer&apos;s disease and other forms of dementia break through the morning fog of forgetfulness. (April 17) Video provided by AP
Powered by NewsLook.com
Boy or Girl? Intersex Awareness Is on the Rise

Boy or Girl? Intersex Awareness Is on the Rise

AP (Apr. 17, 2015) — At least 1 in 5,000 U.S. babies are born each year with intersex conditions _ ambiguous genitals because of genetic glitches or hormone problems. Secrecy and surgery are common. But some doctors and activists are trying to change things. (April 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins