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Age modifies the risk factor profiles for acute kidney injury among recently diagnosed type 2 diabetic patients: a population-based study

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Abstract

The incidence of acute kidney injury (AKI) rises with age and is associated with multiple risk factors. Here, we compared the risk factors for AKI between younger and older incident diabetic patients to examine the trends in risk alteration for individual factors across different age groups. Between 2007 and 2013, we selected all incident type 2 diabetic adults from the Taiwan National Health Insurance registry, stratified based on age: young (< 65 years), old (≥ 65 but < 75 years), and older-old (≥ 75 years). All factors with potential renal influence (e.g., comorbidities, medications, and diagnostics/procedures) were recorded during the study period, with a nested case-controlled approach utilized to identify independent risk factors for AKI in each age group. Totally, 930,709 type 2 diabetic patients were categorized as young (68.7%), old (17.7%), or older-old (13.6%). Older-old patients showed a significantly higher incidence of AKI than the old and the young groups. Cardiovascular morbidities (hypertension, atrial fibrillation, acute coronary syndrome, and cerebrovascular disease) were shown to increase the risk of AKI, although the risk declined with increasing age. Chronic obstructive pulmonary disease and receiving cardiac catheterization elevated the risk of AKI preferentially in the older-old/old and older-old group, respectively, while the administration of angiotensin-converting enzyme/α-blocker and angiotensin receptor blocker/calcium channel blocker reduced the risk of AKI preferentially in the older-old and older-old/old group, respectively. In conclusion, our findings highlight the importance of devising age-specific risk factor panels for AKI in patients with recently diagnosed type 2 diabetes.

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Funding disclosure

The study is financially sponsored by National Taiwan University Hospital BeiHu branch.

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Authors and Affiliations

  1. Department of Medicine, National Taiwan University Hospital BeiHu branch, Taipei, Taiwan

    Chia-Ter Chao

  2. Department of Medicine, National Taiwan University Hospital Jin-Shan branch, New Taipei City, Taiwan

    Chia-Ter Chao

  3. Graduate Institute of Toxicology, School of Medicine, National Taiwan University, Taipei, Taiwan

    Chia-Ter Chao

  4. Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan

    Chia-Ter Chao, Hon-Yen Wu & Jenq-Wen Huang

  5. Geriatric and Community Medicine Research Center, National Taiwan University Hospital BeiHu branch, Taipei, Taiwan

    Chia-Ter Chao

  6. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, NO.17, Xu-Zhou Road, Taipei, 100, Taiwan

    Jui Wang, Hon-Yen Wu & Kuo-Liong Chien

  7. Far-Eastern Memorial Hospital, New Taipei City, Taiwan

    Hon-Yen Wu

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  1. Chia-Ter Chao
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  2. Jui Wang
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  3. Hon-Yen Wu
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  4. Jenq-Wen Huang
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  5. Kuo-Liong Chien
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Contributions

Study design: CTC, KLC; Data analysis: CTC, JW, HYW, KLC; Article drafting: CTC, JW, JWH, KLC; Article approval: all authors.

Corresponding author

Correspondence to Kuo-Liong Chien.

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The sponsors have no role in the study design, data collection, analysis, and result interpretation of this study.

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The authors declare that they have no conflict of interest.

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Chao, CT., Wang, J., Wu, HY. et al. Age modifies the risk factor profiles for acute kidney injury among recently diagnosed type 2 diabetic patients: a population-based study. GeroScience 40, 201–217 (2018). https://doi.org/10.1007/s11357-018-0013-3

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  • DOI: https://doi.org/10.1007/s11357-018-0013-3

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