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dc.contributor.authorGriffin, Tomás P.
dc.contributor.authorO'Shea, Paula M.
dc.contributor.authorSmyth, Andrew
dc.contributor.authorIslam, Md Nahidul
dc.contributor.authorWall, Deirdre
dc.contributor.authorFerguson, John
dc.contributor.authorO'Sullivan, Esther
dc.contributor.authorFinucane, Francis M.
dc.contributor.authorDinneen, Sean F.
dc.contributor.authorDunne, Fidelma P.
dc.contributor.authorLappin, David W.
dc.contributor.authorReddan, Donal N.
dc.contributor.authorBell, Marcia
dc.contributor.authorO'Brien, Timothy
dc.contributor.authorGriffin, Damian G.
dc.contributor.authorGriffin, Matthew D.
dc.identifier.citationGriffin, Tomás P., Shea, Paula M., Smyth, Andrew, Islam, Md Nahidul, Wall, Deirdre, Ferguson, John, Sullivan, Esther, Finucane, Francis M., Dinneen, Sean F., Dunne, Fidelma P., Lappin, David W., Reddan, Donal N., Bell, Marcia, Brien, Timothy, Griffin, Damian G., Griffin, Matthew D. (2021). Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe. BMJ Open Diabetes Research and Care, 9(1). doi:10.1136/bmjdrc-2021-002125en_IE
dc.description.abstractIntroduction This study aimed to determine the prevalence of diabetic kidney disease (DKD) and rapid renal function decline and to identify indices associated with this decline among adults attending a diabetes center in Northern Europe. Research design and methods This is a retrospective cohort study of 4606 patients who attended a diabetes center in Ireland between June 2012 and December 2016. Definition/staging of chronic kidney disease used the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 classification based on data from the most recently attended appointment. Relevant longitudinal trends and variabilities were derived from serial records prior to index visit. Rapid renal function decline was defined based on per cent and absolute rates of estimated glomerular filtration rate (eGFR) change. Multiple linear regression was used to explore the relationships between explanatory variables and per cent eGFR change. Results 42.0% (total), 23.4% (type 1 diabetes), 47.9% (type 2 diabetes) and 32.6% (other diabetes) had DKD. Rapid decline based on per cent change was more frequent in type 2 than in type 1 diabetes (32.8% vs 14.0%, p<0.001). Indices independently associated with rapid eGFR decline included older age, greater number of antihypertensives, higher log-normalized urine albumin to creatinine ratio (LNuACR), serum alkaline phosphatase, thyroid stimulating hormone, variability in systolic blood pressure and variability in LNuACR, lower glycated hemoglobin, high-density lipoprotein cholesterol and diastolic blood pressure, and lack of ACE inhibitor/angiotensin receptor blocker prescription. Conclusions DKD (using the KDIGO 2012 classification) and rapid eGFR decline were highly prevalent among adults attending a hospital-based diabetes clinic in a predominantly Caucasian Northern European country. The burden was greater for adults with type 2 diabetes. Expected as well as potentially novel clinical predictors were identified.en_IE
dc.description.sponsorshipTPG is supported by a Hardiman Scholarship from the College of Medicine, Nursing and Health Science, National University of Ireland Galway and a bursary from the Irish Endocrine Society/Royal College of Physicians of Ireland. The authors are supported by grants from the European Commission [Horizon 2020 Collaborative Health Project NEPHSTROM (grant number 634086; TPG, MNI, MDG), Science Foundation Ireland [REMEDI Strategic Research Cluster (grant number 09/SRC-B1794; MDG), CÚRAM Research Centre (grant number 13/RC/2073_P2; MDG)], HRB, Ireland Grant (grant number: EIA 2017-017) and the European Regional Development Fund. The materials presented and views expressed are the responsibility of the author(s) only. The EU Commission takes no responsibility for any use made of the information set out.en_IE
dc.publisherBMJ Publishing Groupen_IE
dc.relation.ispartofBmj Open Diabetes Research & Careen
dc.rightsAttribution 4.0 International (CC BY 4.0) International
dc.subjectNorthern Europeen_IE
dc.subjectchronic kidney diseaseen_IE
dc.subjecthospital-based diabetes centeren_IE
dc.subjectRenal functionen_IE
dc.titleBurden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europeen_IE
dc.contributor.funderHardiman Research Scholarship, National University of Ireland Galwayen_IE
dc.contributor.funderIrish Endocrine Society/Royal College of Physicians of Irelanden_IE
dc.contributor.funderHorizon 2020en_IE
dc.contributor.funderScience Foundation Irelanden_IE
dc.contributor.funderHealth Research Boarden_IE
dc.contributor.funderEuropean Regional Development Funden_IE
dc.local.contactMatthew Dallas Griffin, Remedi, Biomedical Sciences Buil, Corrib Village, Dangan, Nui Galway. 5436 Email:
dcterms.projectinfo:eu-repo/grantAgreement/EC/H2020::RIA/634086/EU/Novel Stromal Cell Therapy for Diabetic Kidney Disease/NEPHSTROMen_IE
dcterms.projectinfo:eu-repo/grantAgreement/SFI/SFI Strategic Research Cluster/09/SRC/B1794/IE/SRC REMEDI: REMEDI-2: From Research to Human Therapy/en_IE
dcterms.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/13/RC/2073/IE/C�RAM - Centre for Research in Medical Devices/en_IE

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Attribution 4.0 International (CC BY 4.0) International
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