Cargando…
The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study
Renal clearance function and urinary albumin excretion are important markers for diabetic nephropathy. We assessed whether the creatinine clearance rate (CCR) and daily urinary albumin (DUA) excretion, which both require 24-hour urine data, are better predictors of mortality in diabetic inpatients c...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753942/ https://www.ncbi.nlm.nih.gov/pubmed/26871846 http://dx.doi.org/10.1097/MD.0000000000002804 |
_version_ | 1782415945055076352 |
---|---|
author | Lee, I-Te Sheu, Wayne H-H Lin, Shih-Yi |
author_facet | Lee, I-Te Sheu, Wayne H-H Lin, Shih-Yi |
author_sort | Lee, I-Te |
collection | PubMed |
description | Renal clearance function and urinary albumin excretion are important markers for diabetic nephropathy. We assessed whether the creatinine clearance rate (CCR) and daily urinary albumin (DUA) excretion, which both require 24-hour urine data, are better predictors of mortality in diabetic inpatients compared with the estimated glomerular filtration rate (eGFR) and urine albumin–creatinine ratio (ACR). We enrolled 1011 patients who were hospitalized due to poor glucose control, and collected clinical information, including 24-hour urine data, from their medical records. We determined the mortality rate after discharge by examining the national registry data in Taiwan. The subjects had a median follow-up of 6.5 years (interquartile range between 3.5 and 9.6 years). Subjects with a CCR < 60 mL/min and a DUA ≥ 300 mg/d had the highest mortality rate, with a hazard ratio of 3.373 (95% confidence interval = 2.469–4.609), compared with the mortality rate in subjects with a CCR ≥ 60 mL/min and a DUA < 300 mg/d. In terms of predicting mortality in diabetic inpatients, ACR had a similar sensitivity to DUA (40.3% versus 38.0%), but eGFR provided lower sensitivity than CCR (54.5% versus 66.5%). Creatinine clearance rate and DUA have an additive effect on predicting mortality in diabetic inpatients after discharge. Moreover, CCR is a more sensitive predictor of mortality than eGFR. Therefore, determining CCR using 24-hour urine data, as well as either ACR or DUA, should provide better prediction of mortality in diabetic nephropathy patients. |
format | Online Article Text |
id | pubmed-4753942 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-47539422016-02-26 The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study Lee, I-Te Sheu, Wayne H-H Lin, Shih-Yi Medicine (Baltimore) 4300 Renal clearance function and urinary albumin excretion are important markers for diabetic nephropathy. We assessed whether the creatinine clearance rate (CCR) and daily urinary albumin (DUA) excretion, which both require 24-hour urine data, are better predictors of mortality in diabetic inpatients compared with the estimated glomerular filtration rate (eGFR) and urine albumin–creatinine ratio (ACR). We enrolled 1011 patients who were hospitalized due to poor glucose control, and collected clinical information, including 24-hour urine data, from their medical records. We determined the mortality rate after discharge by examining the national registry data in Taiwan. The subjects had a median follow-up of 6.5 years (interquartile range between 3.5 and 9.6 years). Subjects with a CCR < 60 mL/min and a DUA ≥ 300 mg/d had the highest mortality rate, with a hazard ratio of 3.373 (95% confidence interval = 2.469–4.609), compared with the mortality rate in subjects with a CCR ≥ 60 mL/min and a DUA < 300 mg/d. In terms of predicting mortality in diabetic inpatients, ACR had a similar sensitivity to DUA (40.3% versus 38.0%), but eGFR provided lower sensitivity than CCR (54.5% versus 66.5%). Creatinine clearance rate and DUA have an additive effect on predicting mortality in diabetic inpatients after discharge. Moreover, CCR is a more sensitive predictor of mortality than eGFR. Therefore, determining CCR using 24-hour urine data, as well as either ACR or DUA, should provide better prediction of mortality in diabetic nephropathy patients. Wolters Kluwer Health 2016-02-12 /pmc/articles/PMC4753942/ /pubmed/26871846 http://dx.doi.org/10.1097/MD.0000000000002804 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 4300 Lee, I-Te Sheu, Wayne H-H Lin, Shih-Yi The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study |
title | The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study |
title_full | The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study |
title_fullStr | The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study |
title_full_unstemmed | The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study |
title_short | The Impact of Creatinine Clearance Rate, Daily Urinary Albumin, and Their Joint Effect on Predicting Death in Diabetic Inpatients After Discharge: An Observational Study |
title_sort | impact of creatinine clearance rate, daily urinary albumin, and their joint effect on predicting death in diabetic inpatients after discharge: an observational study |
topic | 4300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753942/ https://www.ncbi.nlm.nih.gov/pubmed/26871846 http://dx.doi.org/10.1097/MD.0000000000002804 |
work_keys_str_mv | AT leeite theimpactofcreatinineclearanceratedailyurinaryalbuminandtheirjointeffectonpredictingdeathindiabeticinpatientsafterdischargeanobservationalstudy AT sheuwaynehh theimpactofcreatinineclearanceratedailyurinaryalbuminandtheirjointeffectonpredictingdeathindiabeticinpatientsafterdischargeanobservationalstudy AT linshihyi theimpactofcreatinineclearanceratedailyurinaryalbuminandtheirjointeffectonpredictingdeathindiabeticinpatientsafterdischargeanobservationalstudy AT leeite impactofcreatinineclearanceratedailyurinaryalbuminandtheirjointeffectonpredictingdeathindiabeticinpatientsafterdischargeanobservationalstudy AT sheuwaynehh impactofcreatinineclearanceratedailyurinaryalbuminandtheirjointeffectonpredictingdeathindiabeticinpatientsafterdischargeanobservationalstudy AT linshihyi impactofcreatinineclearanceratedailyurinaryalbuminandtheirjointeffectonpredictingdeathindiabeticinpatientsafterdischargeanobservationalstudy |