Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64)
Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64). The progression of nephropathy from diagnosis of type 2 diabetes has not been well described from a single population. This study sought to describe the development and progressio...
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| Veröffentlicht in: | Kidney international 2003-01, Vol.63 (1), p.225-232 |
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| creator | Adler, Amanda I. Stevens, Richard J. Manley, Sue E. Bilous, Rudy W. Cull, Carole A. Holman, Rury R. UKPDS Group |
| description | Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64).
The progression of nephropathy from diagnosis of type 2 diabetes has not been well described from a single population. This study sought to describe the development and progression through the stages of microalbuminuria, macroalbuminuria, persistently elevated plasma creatinine or renal replacement therapy (RRT), and death.
Using observed and modeled data from 5097 subjects in the UK Prospective Diabetes Study, we measured the annual probability of transition from stage to stage (incidence), prevalence, cumulative incidence, ten-year survival, median duration per stage, and risk of death from all-causes or cardiovascular disease.
From diagnosis of diabetes, progression to microalbuminuria occurred at 2.0% per year, from microalbuminuria to macroalbuminuria at 2.8% per year, and from macroalbuminuria to elevated plasma creatinine (≥175 μmol/L) or renal replacement therapy at 2.3% per year. Ten years following diagnosis of diabetes, the prevalence of microalbuminuria was 24.9%, of macroalbuminuria was 5.3%, and of elevated plasma creatinine or RRT was 0.8%. Patients with elevated plasma creatinine or RRT had an annual death rate of 19.2% (95% confidence interval, CI, 14.0 to 24.4%). There was a trend for increasing risk of cardiovascular death with increasing nephropathy (P < 0.0001), with an annual rate of 0.7% for subjects in the stage of no nephropathy, 2.0% for those with microalbuminuria, 3.5% for those with macroalbuminuria, and 12.1% with elevated plasma creatinine or RRT. Individuals with macroalbuminuria were more likely to die in any year than to develop renal failure.
The proportion of patients with type 2 diabetes who develop microalbuminuria is substantial with one quarter affected by 10 years from diagnosis. Relatively fewer patients develop macroalbuminuria, but in those who do, the death rate exceeds the rate of progression to worse nephropathy. |
| doi_str_mv | 10.1046/j.1523-1755.2003.00712.x |
| format | Article |
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The progression of nephropathy from diagnosis of type 2 diabetes has not been well described from a single population. This study sought to describe the development and progression through the stages of microalbuminuria, macroalbuminuria, persistently elevated plasma creatinine or renal replacement therapy (RRT), and death.
Using observed and modeled data from 5097 subjects in the UK Prospective Diabetes Study, we measured the annual probability of transition from stage to stage (incidence), prevalence, cumulative incidence, ten-year survival, median duration per stage, and risk of death from all-causes or cardiovascular disease.
From diagnosis of diabetes, progression to microalbuminuria occurred at 2.0% per year, from microalbuminuria to macroalbuminuria at 2.8% per year, and from macroalbuminuria to elevated plasma creatinine (≥175 μmol/L) or renal replacement therapy at 2.3% per year. Ten years following diagnosis of diabetes, the prevalence of microalbuminuria was 24.9%, of macroalbuminuria was 5.3%, and of elevated plasma creatinine or RRT was 0.8%. Patients with elevated plasma creatinine or RRT had an annual death rate of 19.2% (95% confidence interval, CI, 14.0 to 24.4%). There was a trend for increasing risk of cardiovascular death with increasing nephropathy (P < 0.0001), with an annual rate of 0.7% for subjects in the stage of no nephropathy, 2.0% for those with microalbuminuria, 3.5% for those with macroalbuminuria, and 12.1% with elevated plasma creatinine or RRT. Individuals with macroalbuminuria were more likely to die in any year than to develop renal failure.
The proportion of patients with type 2 diabetes who develop microalbuminuria is substantial with one quarter affected by 10 years from diagnosis. Relatively fewer patients develop macroalbuminuria, but in those who do, the death rate exceeds the rate of progression to worse nephropathy.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1046/j.1523-1755.2003.00712.x</identifier><identifier>PMID: 12472787</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Albuminuria - drug therapy ; Albuminuria - mortality ; Antihypertensive Agents - therapeutic use ; Associated diseases and complications ; Biological and medical sciences ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - mortality ; Diabetes. Impaired glucose tolerance ; Diabetic Nephropathies - drug therapy ; Diabetic Nephropathies - mortality ; Disease Progression ; end-stage renal disease ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Female ; Humans ; Hypertension, Renal - drug therapy ; Hypertension, Renal - mortality ; Hypoglycemic Agents - therapeutic use ; Incidence ; insulin ; macroalbuminuria ; Male ; Medical sciences ; microalbuminuria ; Middle Aged ; nephropathy ; plasma creatinine ; Prevalence ; Prospective Studies ; type 2 diabetes ; United Kingdom - epidemiology</subject><ispartof>Kidney international, 2003-01, Vol.63 (1), p.225-232</ispartof><rights>2003 International Society of Nephrology</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Jan 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c543t-94b92e5450a68c35433aab82c451a40bfe217612bc51d2d235e1bd7cbb6eb9a13</citedby><cites>FETCH-LOGICAL-c543t-94b92e5450a68c35433aab82c451a40bfe217612bc51d2d235e1bd7cbb6eb9a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14939797$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12472787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adler, Amanda I.</creatorcontrib><creatorcontrib>Stevens, Richard J.</creatorcontrib><creatorcontrib>Manley, Sue E.</creatorcontrib><creatorcontrib>Bilous, Rudy W.</creatorcontrib><creatorcontrib>Cull, Carole A.</creatorcontrib><creatorcontrib>Holman, Rury R.</creatorcontrib><creatorcontrib>UKPDS Group</creatorcontrib><creatorcontrib>UKPDS GROUP</creatorcontrib><title>Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64)</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64).
The progression of nephropathy from diagnosis of type 2 diabetes has not been well described from a single population. This study sought to describe the development and progression through the stages of microalbuminuria, macroalbuminuria, persistently elevated plasma creatinine or renal replacement therapy (RRT), and death.
Using observed and modeled data from 5097 subjects in the UK Prospective Diabetes Study, we measured the annual probability of transition from stage to stage (incidence), prevalence, cumulative incidence, ten-year survival, median duration per stage, and risk of death from all-causes or cardiovascular disease.
From diagnosis of diabetes, progression to microalbuminuria occurred at 2.0% per year, from microalbuminuria to macroalbuminuria at 2.8% per year, and from macroalbuminuria to elevated plasma creatinine (≥175 μmol/L) or renal replacement therapy at 2.3% per year. Ten years following diagnosis of diabetes, the prevalence of microalbuminuria was 24.9%, of macroalbuminuria was 5.3%, and of elevated plasma creatinine or RRT was 0.8%. Patients with elevated plasma creatinine or RRT had an annual death rate of 19.2% (95% confidence interval, CI, 14.0 to 24.4%). There was a trend for increasing risk of cardiovascular death with increasing nephropathy (P < 0.0001), with an annual rate of 0.7% for subjects in the stage of no nephropathy, 2.0% for those with microalbuminuria, 3.5% for those with macroalbuminuria, and 12.1% with elevated plasma creatinine or RRT. Individuals with macroalbuminuria were more likely to die in any year than to develop renal failure.
The proportion of patients with type 2 diabetes who develop microalbuminuria is substantial with one quarter affected by 10 years from diagnosis. Relatively fewer patients develop macroalbuminuria, but in those who do, the death rate exceeds the rate of progression to worse nephropathy.</description><subject>Adult</subject><subject>Albuminuria - drug therapy</subject><subject>Albuminuria - mortality</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Nephropathies - drug therapy</subject><subject>Diabetic Nephropathies - mortality</subject><subject>Disease Progression</subject><subject>end-stage renal disease</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Renal - drug therapy</subject><subject>Hypertension, Renal - mortality</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>insulin</subject><subject>macroalbuminuria</subject><subject>Male</subject><subject>Medical sciences</subject><subject>microalbuminuria</subject><subject>Middle Aged</subject><subject>nephropathy</subject><subject>plasma creatinine</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>type 2 diabetes</subject><subject>United Kingdom - epidemiology</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkUtv1DAQgC0EokvhLyALCQSHBD_iOOEGXV5qJSq1e7Yce9L1KusEO1m6_x6HjajEhZM1nm9GM_MhhCnJKSnK97ucCsYzKoXIGSE8J0RSlt8_Qqu_icdoRUglMiZ4dYaexbgjKa45eYrOKCskk5VcoV9rOEDXD3vwI9be4iH0dwFidL3HfYs9DNvQD3rcHrHzeDwOgBm2TjcwQvyAb7eAN96NYPGl83e23-Pr0McBzOgOgNcLiG_GyR7x283l9foGl8W75-hJq7sIL5b3HG2-fL69-JZd_fj6_eLjVWZEwcesLpqagSgE0WVlePrjWjcVM4WguiBNC4zKkrLGCGqZZVwAbaw0TVNCU2vKz9GbU9-0188J4qj2LhroOu2hn6KSrKqoEDKBr_4Bd_0UfJpNMUooqVldJqg6QSbtGAO0aghur8NRUaJmM2qnZgFqFqBmM-qPGXWfSl8u_admD_ahcFGRgNcLoKPRXRu0Ny4-cEXNa1nP3KcTB-lsBwdBRePAG7AupKsr27v_T_MbM5yrog</recordid><startdate>200301</startdate><enddate>200301</enddate><creator>Adler, Amanda I.</creator><creator>Stevens, Richard J.</creator><creator>Manley, Sue E.</creator><creator>Bilous, Rudy W.</creator><creator>Cull, Carole A.</creator><creator>Holman, Rury R.</creator><creator>UKPDS Group</creator><general>Elsevier Inc</general><general>Nature Publishing</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200301</creationdate><title>Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64)</title><author>Adler, Amanda I. ; Stevens, Richard J. ; Manley, Sue E. ; Bilous, Rudy W. ; Cull, Carole A. ; Holman, Rury R. ; UKPDS Group</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c543t-94b92e5450a68c35433aab82c451a40bfe217612bc51d2d235e1bd7cbb6eb9a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Albuminuria - drug therapy</topic><topic>Albuminuria - mortality</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Associated diseases and complications</topic><topic>Biological and medical sciences</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Nephropathies - drug therapy</topic><topic>Diabetic Nephropathies - mortality</topic><topic>Disease Progression</topic><topic>end-stage renal disease</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension, Renal - drug therapy</topic><topic>Hypertension, Renal - mortality</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>insulin</topic><topic>macroalbuminuria</topic><topic>Male</topic><topic>Medical sciences</topic><topic>microalbuminuria</topic><topic>Middle Aged</topic><topic>nephropathy</topic><topic>plasma creatinine</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>type 2 diabetes</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adler, Amanda I.</creatorcontrib><creatorcontrib>Stevens, Richard J.</creatorcontrib><creatorcontrib>Manley, Sue E.</creatorcontrib><creatorcontrib>Bilous, Rudy W.</creatorcontrib><creatorcontrib>Cull, Carole A.</creatorcontrib><creatorcontrib>Holman, Rury R.</creatorcontrib><creatorcontrib>UKPDS Group</creatorcontrib><creatorcontrib>UKPDS GROUP</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adler, Amanda I.</au><au>Stevens, Richard J.</au><au>Manley, Sue E.</au><au>Bilous, Rudy W.</au><au>Cull, Carole A.</au><au>Holman, Rury R.</au><au>UKPDS Group</au><aucorp>UKPDS GROUP</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64)</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2003-01</date><risdate>2003</risdate><volume>63</volume><issue>1</issue><spage>225</spage><epage>232</epage><pages>225-232</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64).
The progression of nephropathy from diagnosis of type 2 diabetes has not been well described from a single population. This study sought to describe the development and progression through the stages of microalbuminuria, macroalbuminuria, persistently elevated plasma creatinine or renal replacement therapy (RRT), and death.
Using observed and modeled data from 5097 subjects in the UK Prospective Diabetes Study, we measured the annual probability of transition from stage to stage (incidence), prevalence, cumulative incidence, ten-year survival, median duration per stage, and risk of death from all-causes or cardiovascular disease.
From diagnosis of diabetes, progression to microalbuminuria occurred at 2.0% per year, from microalbuminuria to macroalbuminuria at 2.8% per year, and from macroalbuminuria to elevated plasma creatinine (≥175 μmol/L) or renal replacement therapy at 2.3% per year. Ten years following diagnosis of diabetes, the prevalence of microalbuminuria was 24.9%, of macroalbuminuria was 5.3%, and of elevated plasma creatinine or RRT was 0.8%. Patients with elevated plasma creatinine or RRT had an annual death rate of 19.2% (95% confidence interval, CI, 14.0 to 24.4%). There was a trend for increasing risk of cardiovascular death with increasing nephropathy (P < 0.0001), with an annual rate of 0.7% for subjects in the stage of no nephropathy, 2.0% for those with microalbuminuria, 3.5% for those with macroalbuminuria, and 12.1% with elevated plasma creatinine or RRT. Individuals with macroalbuminuria were more likely to die in any year than to develop renal failure.
The proportion of patients with type 2 diabetes who develop microalbuminuria is substantial with one quarter affected by 10 years from diagnosis. Relatively fewer patients develop macroalbuminuria, but in those who do, the death rate exceeds the rate of progression to worse nephropathy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12472787</pmid><doi>10.1046/j.1523-1755.2003.00712.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Albuminuria - drug therapy Albuminuria - mortality Antihypertensive Agents - therapeutic use Associated diseases and complications Biological and medical sciences Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - mortality Diabetes. Impaired glucose tolerance Diabetic Nephropathies - drug therapy Diabetic Nephropathies - mortality Disease Progression end-stage renal disease Endocrine pancreas. Apud cells (diseases) Endocrinopathies Female Humans Hypertension, Renal - drug therapy Hypertension, Renal - mortality Hypoglycemic Agents - therapeutic use Incidence insulin macroalbuminuria Male Medical sciences microalbuminuria Middle Aged nephropathy plasma creatinine Prevalence Prospective Studies type 2 diabetes United Kingdom - epidemiology |
| title | Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64) |
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