Abstract
BackgroundThe prevalence of type 2 diabetes has grown significantly in China. However, little is known about the survival outcome of people with type 2 diabetes and diabetic kidney disease (DKD). The purpose of this study is to examine the survival of this population and the risk factors for mortality in one suburb cohort of Beijing, China.MethodsFour hundred and forty-five people with DKD (48.8% male, age at onset of diabetes 48.8 ± 11.0 years, age at enrollment 57.5 ± 11.6 years) were enrolled in one suburb of Beijing, China between January 1st, 2003 and December 31st, 2015. Mortality ascertainment was censored by December 31st, 2015. Survival analysis was performed by Kaplan–Meier analysis, and Cox proportional hazards regression models were served for risk factor analysis of mortality. The Chiang method was used to estimate life expectancy by age.ResultsA total of 78 deaths were identified during the 3232 person-years of follow-up. Multivariate Cox regression analysis showed significantly higher risks of mortality with respect to older age, higher systolic blood pressure (SBP), lower body mass index (BMI) and lower estimated glomerular filtration rate (eGFR). The life expectancy at age of 50 was estimated to be 12.3 (95%, CI: 9.0–16.1) years. Circulatory disease was the leading cause of death in this population (accounting for 43.6% of all deaths), followed by diabetic complications (33.3%) and respiratory disease (6.4%).ConclusionsData from one Chinese cohort from 2003 through 2015 showed that people with DKD faced higher risk of death and shorter life expectancy. Factors significantly increasing risk of death included older age, higher SBP, lower BMI and lower eGFR. There is an urgent need to early detection, closely monitoring and effective intervention on DKD.
Highlights
The prevalence of type 2 diabetes has grown significantly in China
diabetic kidney disease (DKD) is defined as diabetes with kidney involvement, presenting as albuminuria and/or an impaired glomerular filtration rate (GFR)
A 21-year follow-up study on the Steno-2 randomized trial revealed that compared with conventional treatment, intensified and multifactorial intervention of type 2 diabetes with microalbuminuria for 7.8 years increases median life expectancy by 7.9 years, and that this increase in lifespan is matched by years without incident cardiovascular disease (CVD) [9]
Summary
Little is known about the survival outcome of people with type 2 diabetes and diabetic kidney disease (DKD). A study from China using a general population-based, nationally representative sample of 47,204 participants from 2009 through 2010 revealed that approximately 21.3% of the people with diabetes were classified as having DKD, and 60% of the. Given the adverse health outcomes of DKD, there have been many studies that investigated the effects of the early intervention on such individuals. A 21-year follow-up study on the Steno-2 randomized trial revealed that compared with conventional treatment, intensified and multifactorial intervention of type 2 diabetes with microalbuminuria for 7.8 years increases median life expectancy by 7.9 years, and that this increase in lifespan is matched by years without incident CVD [9]
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