Tao Ping, Chien Ching-Wen, Liu Chao, Zheng Jinghang, Sun Dongping, Zeng Jibin, Song Qunli, Liu Yuzhou, Tung Tao-Hsin, Kang Linlin
Department of Medical Affairs & Planning, Kaohsiung Veterans General Hospital, Taiwan, China.
Institute for Hospital Management, Tsinghua University, Shenzhen Campus, Shenzhen, China.
Heliyon. 2024 Mar 27;10(7):e28780. doi: 10.1016/j.heliyon.2024.e28780. eCollection 2024 Apr 15.
Diabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease.
By retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups.
After adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277-1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus.
There is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.
糖尿病和慢性肾脏病是具有多种病因的多因素疾病，二者具有相似的病理生理学特征。这项全国性队列研究考察了糖尿病对慢性肾脏病后续发展的影响。
通过检索2005年纵向健康保险数据库，本研究纳入了5121例糖尿病患者，并选取了5121例非糖尿病患者作为对照组，这些非糖尿病患者在性别、年龄和查尔森合并症指数方面进行了匹配。使用Cox比例风险回归分析计算慢性肾脏病的调整后风险比。采用Kaplan-Meier分析来估计糖尿病组和对照组中慢性肾脏病发生率的累积发生率。
在对性别、年龄和查尔森合并症指数评分进行调整后，糖尿病组发生慢性肾脏病的风险比对照组高1.380倍（95%置信区间：1.277 - 1.492）。进一步的分层分析表明，与非糖尿病患者相比，糖尿病患者无论性别、年龄和查尔森合并症指数评分如何，发生慢性肾脏病的风险均显著更高。
糖尿病有可能是慢性肾脏病发展的独立危险因素。对糖尿病进行早期筛查和监测在预防慢性肾脏病方面似乎非常重要。
