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.

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 September 2, 2014 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 September 2, 2014).

Share This




More Health & Medicine News

Tuesday, September 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Snack Attack: Study Says Action Movies Make You Snack More

Snack Attack: Study Says Action Movies Make You Snack More

Newsy (Sep. 2, 2014) — You're more likely to gain weight while watching action flicks than you are watching other types of programming, says a new study published in JAMA. Video provided by Newsy
Powered by NewsLook.com
U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

U.N. Says Ebola Travel Restrictions Will Cause Food Shortage

Newsy (Sep. 2, 2014) — The U.N. says the problem is two-fold — quarantine zones and travel restrictions are limiting the movement of both people and food. Video provided by Newsy
Powered by NewsLook.com
Get on Your Bike! London Cycling Popularity Soars Despite Danger

Get on Your Bike! London Cycling Popularity Soars Despite Danger

AFP (Sep. 1, 2014) — Wedged between buses, lorries and cars, cycling in London isn't for the faint hearted. Nevertheless the number of people choosing to bike in the British capital has doubled over the past 15 years. Duration: 02:27 Video provided by AFP
Powered by NewsLook.com
Can You Train Your Brain To Eat Healthy?

Can You Train Your Brain To Eat Healthy?

Newsy (Sep. 1, 2014) — New research says if you condition yourself to eat healthy foods, eventually you'll crave them instead of junk food. Video provided by Newsy
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:
from the past week

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