ArticleBMJ open diabetes research & care2020
Conditions, pathogenesis, and progression of diabetic kidney disease and early decliner in Japan.
Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 34 papers.
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34 citing papers in PubMed, 51 citations in OpenAlex.
- Reduction in the magnitude of serum potassium elevation in combination therapy with esaxerenone (CS-3150) and sodium-glucose cotransporter 2 inhibitor in patients with diabetic kidney disease: Subanalysis of two phase III studies.Journal of diabetes investigation · 2022Trial
- Risk factors for persistent decline in eGFR of Japanese patients with diabetes: Analysis using a large-scale diabetes registry J-DREAMS.Journal of diabetes investigation · 2026Article
- Potential Association Between Darbepoetin Alfa Administration and Reduced Proteinuria in Real-World Clinical Practice: A Post Hoc Analysis of the BRIGHTEN Study.Nephrology (Carlton, Vic.) · 2025Observational
- Implementation of Established Global Guidelines in the Management of CKD in Patients with Type 2 Diabetes in Asia.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Risk factors for nephropathy in individuals with new-onset type 2 diabetes undergoing treatment for hypertension: A retrospective analysis using the Diagnosis Procedure Combination database.Annals of clinical epidemiology · 2025Article
- Renal function trajectories of Japanese adults with diabetic kidney disease on different diet therapies including energy-restricted and low-carbohydrate diets: a retrospective cohort study.Diabetology international · 2025Article
- Predicting rapid decline in kidney function among type 2 diabetes patients: A machine learning approach.Heliyon · 2025Article
- Nomenclature of renal involvement in diabetes mellitus: unify to manage diversity.Frontiers in medicine · 2025Review
- COVID-19 in discharged patients with diabetes and chronic kidney disease: one-year follow-up and evaluation.Frontiers in endocrinology · 2025Observational
- Risk factors for rapid kidney function decline in diabetes patients.Renal failure · 2024Review
- Risk factors for chronic kidney disease progression over 20 years for primary prevention in Japanese individuals at a preventive medicine research center: Focus on the influence of plasma glucose levels.Journal of diabetes investigation · 2024Article
- Irbesartan ameliorates diabetic kidney injury inJournal of translational internal medicine · 2024Article
- Strategies to address diabetic kidney disease burden in Mexico: a narrative review by the Mexican College of Nephrologists.Frontiers in medicine · 2024Review
- Trajectories of kidney function and risk of mortality.International journal of epidemiology · 2023Article
- Article
- Lost in translation: assessing the nomenclature change for diabetic kidney disease in Japan.Diabetology international · 2023Review
- Renoprotective potential of concomittant medications with SGLT2 inhibitors and renin-angiotensin system inhibitors in diabetic nephropathy without albuminuria: a retrospective cohort study.Scientific reports · 2023Article
- Burden and predictors of diabetic kidney disease in an adult Ugandan population with new-onset diabetes.BMC research notes · 2023Article
- Independent risk factors of rapid glomerular filtration rate decline in patients with type 2 diabetes with preserved kidney function and normoalbuminuria: A multicenter cohort study.Journal of diabetes investigation · 2023Observational
- Combination of Risks of BMI and Health-Related Lifestyles on Kidney Function in the Prediabetic Japanese Population: A Prospective Cohort Study.International journal of environmental research and public health · 2023Article
Corrections and comments
- Erratum issuedCorrection:2020
Authors and funding
20 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveGlomerular filtration rate (GFR) decreases without or prior to the development of albuminuria in many patients with diabetes. Therefore, albuminuria and/or a low GFR in patients with diabetes is referred to as diabetic kidney disease (DKD). A certain proportion of patients with diabetes show a rapid progressive decline in renal function in a unidirectional manner and are termed early decliners. This study aimed to elucidate the prevalence of DKD and early decliners and clarify their risk factors. RESEARCH DESIGN AND
methodsThis combination cross-sectional and cohort study included 2385 patients with diabetes from 15 hospitals. We defined DKD as a urinary albumin to creatinine ratio (ACR) ≥30 mg/gCr and/or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². We classified patients into four groups based on the presence or absence of albuminuria and a decrease in eGFR to reveal the risk factors for DKD. We also performed a trajectory analysis and specified the prevalence and risk factors of early decliners with sequential eGFR data of 1955 patients in five facilities.
resultsOf our cohort, 52% had DKD. Above all, 12% with a low eGFR but no albuminuria had no traditional risk factors, such as elevated glycated hemoglobin, elevated blood pressure, or diabetic retinopathy in contrast to patients with albuminuria but normal eGFR. Additionally, 14% of our patients were early decliners. Older age, higher basal eGFR, higher ACR, and higher systolic blood pressure were significantly associated with early decliners.
conclusionsThe prevalence of DKD in this cohort was larger than ever reported. By testing eGFR yearly and identifying risk factors in the early phase of diabetes, we can identify patients at high risk of developing end-stage renal disease.
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