Abstract: SA-PO161
BP and Hemoglobin A1c Threshold Associated with Higher Prevalence of CKD in Elderly People with Diabetes
Session Information
- Diabetic Kidney Disease: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Park, Jee eun, Kangwon National University Hospital, Chuncheon, Korea (the Republic of)
- Lee, Eun jeong, Samsung Medical Center, Seoul, Seoul, Korea (the Republic of)
- Huh, Wooseong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
- Kim, Dae Joong, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
- Lee, Jung eun, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
Background
Chronic kidney disease (CKD) is a major health problem in elderly with diabetes. The study examined the clinical parameters associated with CKD in elderly diabetes, stratified by age groups.
Methods
Total 3068 patients with diabetes ≥ 65 years old (YO) were identified. CKD was defined as albuminuria or eGFR < 60mL/min/1.73m2. CKD prevalence was analyzed according to age (65-69, 70-74, ≥75 YO), HbA1c (<6.5%, intermediate, ≥7.5%) and blood pressure (BP) (<130/80, intermediate, ≥140/90mmHg).
Results
CKD prevalence increased with age (65-69 YO group: 40%, 70-74 YO group: 51%, ≥75 YO group: 67%, P < 0.001). CKD prevalence increased with HbA1c in 65-69, 70-74 YO group, but not in ≥75 YO group (P<0.001, P<0.001 and P=0.081 for trend, respectively). With higher BP levels, CKD prevalence also increased in 65-69, 70-74 YO group, but not in ≥75 YO group (P=0.002, P<0.001 and P=0.281 for trend, respectively). Multivariate analysis showed that age, sex, body mass index, HbA1c ≥7.5%, BP ≥140/90mmHg, diabetes duration were associated with CKD. However, when stratified by age, higher HbA1c and BP were not associated with risk of CKD in subjects ≥75 YO (Table 1).
Conclusion
Overall, the thresholds associated with increased prevalence of CKD were 7.5% for HbA1c level and 140/90 mmHg for BP in elderly diabetes. However, the association of CKD with BP and HbA1c levels were not evident in subjects ≥75 YO.
Table 1. Multivariate logistic regression analysis to examine the associations between covariates and chronic kidney disease
| All | 65-69 YO | 70-74 YO | ≥75 YO | |||||
| OR (95% CI) | P value | OR (95% CI) | P value | OR (95% CI) | P value | OR (95% CI) | P value | |
| Age (x 1 year) | 1.1 (1.083-1.118) | <0.001 | 1.038 (0.957-1.125) | 0.371 | 1.119 (1.016-1.231) | 0.022 | 1.122 (1.062-1.185) | <0.001 |
| Male sex | 1.293 (1.103-1.517) | 0.002 | 1.31 (1.04-1.65) | 0.022 | 1.679 (1.278-2.207) | <0.001 | 1.06 (0.76-1.479) | 0.732 |
| Body mass index (x 1kg/m2) | 1.061 (1.034-1.089) | <0.001 | 1.087 (1.045-1.131) | <0.001 | 1.077 (1.031-1.125) | 0.001 | 1.082 (1.026-1.14) | 0.003 |
| BP category (ref. <130/80 mmHg) intermediate ≥140/90mmHg | 1.012 (0.848-1.208) 1.502 (1.183-1.907) | 0.002 0.893 0.001 | 1.007 (0.778-1.304) 1.474 (1.026-2.117) | 0.09 0.957 0.036 | 1.157 (0.847-1.58) 1.862 (1.22-2.841) | 0.016 0.358 0.004 | 0.78 (0.531-1.147) 1.066 (0.658-1.728) | 0.31 0.207 0.794 |
| Diabetes duration (x 1 year) | 1.038 (1.028-1.048) | <0.001 | 1.052 (1.036-1.069) | <0.001 | 1.028 (1.012-1.045) | 0.001 | 1.025 (1.007-1.044) | 0.007 |
| HbA1c category (ref. < 6.5%) intermediate ≥7.5% | 0.934 (0.772-1.132) 1.423 (1.149-1.762) | <0.001 0.487 0.001 | 1.175 (0.875-1.578) 1.427 (1.032-1.973) | 0.091 0.283 0.031 | 0.82 (0.595-1.132) 1.806 (1.254-2.603) | <0.001 0.228 0.002 | 0.791 (0.523-1.197) 1.229 (0.767-1.968) | 0.085 0.268 0.391 |
| Hypertension | 1.249 (0.972-1.605) | 0.082 | 1.491 (1.005-2.21) | 0.047 | 1.047 (0.67-1.636) | 0.842 | 1.257 (0.787-2.005) | 0.338 |
| Myocardial infarct | 1.311 (0.967-1.779) | 0.081 | 1.741 (1.071-2.831) | 0.025 | 0.864 (0.53-1.408) | 0.557 | 1.907 (0.945-3.846) | 0.071 |
| Dementia | 1.314 (0.803-2.149) | 0.277 | 1.843 (0.726-4.681) | 0.199 | 1.532 (0.63-3.729) | 0.347 | 1.068 (0.498-2.288) | 0.866 |
OR, Odds ratio; CI, Confidential interval; BP, Blood pressure; ref., reference