Evidence map›Paper›PMID 23362314›Full record

ArticleJournal of the American Society of Nephrology : JASN2013

Kidney disease and increased mortality risk in type 2 diabetes.

Maryam Afkarian, Michael C Sachs, Bryan Kestenbaum, Irl B Hirsch, Katherine R Tuttle, Jonathan Himmelfarb, Ian H de Boer

3 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Society of Nephrology : JASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 690 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
690citing papers in PubMed, 9 pooled it
28.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02964585 phase4completedstarted 2016, after this paper: background citation

Role of Canagliflozin on Gene Expression and Function of CD34+ Endothelial Progenitor Cells and Renal Function in Patients With Type 2 Diabetes

Ran2016Enrolled34Registered outcomes18Posted comparisons0ConditionsType 2 Diabetes MellitusArmsCanagliflozin, Placebo
PMID 17179929PMID 33581737PMID 26378978PMID 24631482PMID 24357209PMID 24334174PMID 19339628PMID 17562958PMID 16148285PMID 16028691other papers from this trial
Open the trial in the graph
NCT04626323 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

Open, Randomized, Unicenter Study Comparing Metabolic Surgery With Intensive Medical Therapy to Treat Diabetic Kidney Disease

TypeinterventionalSponsorHospital Alemão Oswaldo CruzRan2021 to 2024Enrolled60ConditionsDiabetes Mellitus, Type 2, Kidney Disease, Chronic, Kidney InjuryArmsRoux-en-Y gastric bypass, Best medical treatment
NCT07434791 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

GOaL Directed-STrategic Approach With New Disease-modifying theraApies to Reduce Kidney and Cardiovascular Risk in Patients With Diabetic Kidney Disease

TypeinterventionalSponsorSunnybrook Health Sciences CentreRan2026 to 2029Enrolled100ConditionsDiabetic Kidney Disease (DKD)ArmsEarly goal-directed Cardio-Kidney-Metabolic (CKM) care, Standard care (Comparison arm)
3 · Its place in the literature

Who cites it

690 citing papers in PubMed, 9 syntheses or guidelines pooled it, 1,228 citations in OpenAlex.

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  10. Effect of semaglutide on COVID-19 and other infections: an analysis from the FLOW randomized clinical trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
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  13. COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using a UACR Endpoint (CONFIDENCE) trial: baseline clinical characteristics.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025 · on this map
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630 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Maryam AfkarianKidney Research Institute and Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA 98014, USA. afkarian@u.washington.edu
Michael C Sachs
Bryan Kestenbaum
Irl B Hirsch
Katherine R Tuttle
Jonathan Himmelfarb
Ian H de Boer
University of Washington · US

Funding

Phosphorus and Vitamin D Metabolism and Cardiovascular Outcomes: The multi-ethniR01HL096875 · NHLBI · UNIVERSITY OF WASHINGTON · PI DE BOER, IAN H, KESTENBAUM, BRYAN R · 2010 to 2019
$5.2M
Randomized trial of vitamin D and omega-3 fatty acids for diabetic kidney diseaseR01DK088762 · NIDDK · UNIVERSITY OF WASHINGTON · PI DE BOER, IAN H · 2010 to 2019
$4.7M
Oxidative Stress in Chronic Kidney DiseaseR01HL070938 · NHLBI · UNIVERSITY OF WASHINGTON · PI HIMMELFARB, JONATHAN, IKIZLER, TALAT ALP · 2003 to 2012
$3.2M
Insulin Resistance in Chronic Kidney DiseaseR01DK087726 · NIDDK · UNIVERSITY OF WASHINGTON · PI DE BOER, IAN H · 2010 to 2013
$1.9M
Molecular signatures of diabetic kidney diseaseR01DK104706 · NIDDK · UNIVERSITY OF WASHINGTON · PI AFKARIAN, MARYAM · 2015 to 2017
$1.3M
Identifying urinary biomarkers for early type 2 diabetic nephropathyK23DK089017 · NIDDK · UNIVERSITY OF WASHINGTON · PI AFKARIAN, MARYAM · 2010 to 2014
$745k
NHLBI NIH HHS 1R01HL096875NHLBI NIH HHS 5R01HL070938-06NHLBI NIH HHS R01 HL070938NHLBI NIH HHS R01 HL096875NIDDK NIH HHS 1R01DK087726NIDDK NIH HHS 1R01DK088762NIDDK NIH HHS 5K23DK089017-02NIDDK NIH HHS K23 DK089017NIDDK NIH HHS R01 DK087726NIDDK NIH HHS R01 DK088762NIDDK NIH HHS R01 DK104706
6 · The paper itself

Abstract

Type 2 diabetes associates with increased risk of mortality, but how kidney disease contributes to this mortality risk among individuals with type 2 diabetes is not completely understood. Here, we examined 10-year cumulative mortality by diabetes and kidney disease status for 15,046 participants in the Third National Health and Nutrition Examination Survey (NHANES III) by linking baseline data from NHANES III with the National Death Index. Kidney disease, defined as urinary albumin/creatinine ratio ≥30 mg/g and/or estimated GFR ≤60 ml/min per 1.73 m(2), was present in 9.4% and 42.3% of individuals without and with type 2 diabetes, respectively. Among people without diabetes or kidney disease (reference group), 10-year cumulative all-cause mortality was 7.7% (95% confidence interval [95% CI], 7.0%-8.3%), standardized to population age, sex, and race. Among individuals with diabetes but without kidney disease, standardized mortality was 11.5% (95% CI, 7.9%-15.2%), representing an absolute risk difference with the reference group of 3.9% (95% CI, 0.1%-7.7%), adjusted for demographics, and 3.4% (95% CI, -0.3% to 7.0%) when further adjusted for smoking, BP, and cholesterol. Among individuals with both diabetes and kidney disease, standardized mortality was 31.1% (95% CI, 24.7%-37.5%), representing an absolute risk difference with the reference group of 23.4% (95% CI, 17.0%-29.9%), adjusted for demographics, and 23.4% (95% CI, 17.2%-29.6%) when further adjusted. We observed similar patterns for cardiovascular and noncardiovascular mortality. In conclusion, those with kidney disease predominantly account for the increased mortality observed in type 2 diabetes.

Indexed as

AdultAgedAlbuminuriaDiabetes Mellitus, Type 2Diabetic NephropathiesFemaleFollow-Up StudiesGlomerular Filtration RateHumansMaleMiddle AgedNutrition SurveysPrevalenceRisk FactorsUnited States

Identifiers

PMID23362314
PMCPMC3559486
OpenAlexW2114598208

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.