Incidence and associations of chronic kidney disease in community participants with diabetes: A 5-year prospective analysis of the EXTEND45 study

Louisa Sukkar; Amy Kang; Carinna Hockham; Tamara Young; Min Jun; Celine Foote; Roberto Pecoits-Filho; Brendon Neuen; Kris Rogers; Carol Pollock; Alan Cass; David Sullivan; Germaine Wong; John Knight; David Peiris; Martin Gallagher; Meg Jardine

doi:10.2337/dc19-1803

Incidence and associations of chronic kidney disease in community participants with diabetes: A 5-year prospective analysis of the EXTEND45 study

Louisa Sukkar, Amy Kang, Carinna Hockham, Tamara Young, Min Jun, Celine Foote, Roberto Pecoits-Filho, Brendon Neuen, Kris Rogers, Carol Pollock, Alan Cass, David Sullivan, Germaine Wong, John Knight, David Peiris, Martin Gallagher, Meg Jardine

Wellbeing and Preventable Chronic Disease

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective: To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² in people with diabetes.

Research design and methods: Weidentified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m² recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m² at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m² and multivariable Cox regression to examine factors associated with the study outcome.

Results: Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m² over a median follow-up time of 5.7 years (interquartile range, 3.0- 5.9 years). The eGFR <60 mL/min/1.73m² incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4- 4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27).

Conclusions: In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m² was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence.

Original language	English
Pages (from-to)	982-990
Number of pages	9
Journal	Diabetes Care
Volume	43
Issue number	5
DOIs	https://doi.org/10.2337/dc19-1803
Publication status	Published - May 2020

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10.2337/dc19-1803

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Sukkar, L., Kang, A., Hockham, C., Young, T., Jun, M., Foote, C., Pecoits-Filho, R., Neuen, B., Rogers, K., Pollock, C., Cass, A., Sullivan, D., Wong, G., Knight, J., Peiris, D., Gallagher, M., & Jardine, M. (2020). Incidence and associations of chronic kidney disease in community participants with diabetes: A 5-year prospective analysis of the EXTEND45 study. Diabetes Care, 43(5), 982-990. https://doi.org/10.2337/dc19-1803

@article{94a29c47ea1b4729875abf381c991a12,

title = "Incidence and associations of chronic kidney disease in community participants with diabetes: A 5-year prospective analysis of the EXTEND45 study",

abstract = "Objective: To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in people with diabetes. Research design and methods: Weidentified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m2 recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m2 and multivariable Cox regression to examine factors associated with the study outcome. Results: Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m2 over a median follow-up time of 5.7 years (interquartile range, 3.0- 5.9 years). The eGFR <60 mL/min/1.73m2 incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4- 4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27). Conclusions: In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m2 was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence.",

author = "Louisa Sukkar and Amy Kang and Carinna Hockham and Tamara Young and Min Jun and Celine Foote and Roberto Pecoits-Filho and Brendon Neuen and Kris Rogers and Carol Pollock and Alan Cass and David Sullivan and Germaine Wong and John Knight and David Peiris and Martin Gallagher and Meg Jardine",

year = "2020",

month = may,

doi = "10.2337/dc19-1803",

language = "English",

volume = "43",

pages = "982--990",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association",

number = "5",

}

Sukkar, L, Kang, A, Hockham, C, Young, T, Jun, M, Foote, C, Pecoits-Filho, R, Neuen, B, Rogers, K, Pollock, C, Cass, A, Sullivan, D, Wong, G, Knight, J, Peiris, D, Gallagher, M & Jardine, M 2020, 'Incidence and associations of chronic kidney disease in community participants with diabetes: A 5-year prospective analysis of the EXTEND45 study', Diabetes Care, vol. 43, no. 5, pp. 982-990. https://doi.org/10.2337/dc19-1803

TY - JOUR

T1 - Incidence and associations of chronic kidney disease in community participants with diabetes

T2 - A 5-year prospective analysis of the EXTEND45 study

AU - Sukkar, Louisa

AU - Kang, Amy

AU - Hockham, Carinna

AU - Young, Tamara

AU - Jun, Min

AU - Foote, Celine

AU - Pecoits-Filho, Roberto

AU - Neuen, Brendon

AU - Rogers, Kris

AU - Pollock, Carol

AU - Cass, Alan

AU - Sullivan, David

AU - Wong, Germaine

AU - Knight, John

AU - Peiris, David

AU - Gallagher, Martin

AU - Jardine, Meg

PY - 2020/5

Y1 - 2020/5

N2 - Objective: To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in people with diabetes. Research design and methods: Weidentified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m2 recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m2 and multivariable Cox regression to examine factors associated with the study outcome. Results: Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m2 over a median follow-up time of 5.7 years (interquartile range, 3.0- 5.9 years). The eGFR <60 mL/min/1.73m2 incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4- 4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27). Conclusions: In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m2 was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence.

AB - Objective: To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in people with diabetes. Research design and methods: Weidentified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006-2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m2 recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m2 and multivariable Cox regression to examine factors associated with the study outcome. Results: Of 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m2 over a median follow-up time of 5.7 years (interquartile range, 3.0- 5.9 years). The eGFR <60 mL/min/1.73m2 incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4- 4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase; 95% CI 1.19-1.26), geography (outer regional and remote versus major city: 1.36; 1.17-1.58), obesity (obese class III versus normal: 1.44; 1.16-1.80), and the presence of hypertension (1.52; 1.33-1.73), coronary heart disease (1.13; 1.02-1.24), cancer (1.30; 1.14-1.50), and depression/anxiety (1.14; 1.01-1.27). Conclusions: In participants with diabetes, the incidence of an eGFR <60 mL/min/1.73 m2 was high. Older age, remoteness of residence, and the presence of various comorbid conditions were associated with higher incidence.

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U2 - 10.2337/dc19-1803

DO - 10.2337/dc19-1803

M3 - Article

C2 - 32161053

AN - SCOPUS:85083913467

SN - 0149-5992

VL - 43

SP - 982

EP - 990

JO - Diabetes Care

JF - Diabetes Care

IS - 5

ER -

Incidence and associations of chronic kidney disease in community participants with diabetes: A 5-year prospective analysis of the EXTEND45 study

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