Monday, June 28, 2010: Free Communications
Bibliographic record
Abstract
Introduction and Aims: Type 2 diabetes (T2D) is one of the leading causes of end stage renal disease (ESRD) but not all patients with T2D develop renal dysfunction (albuminuria and/or renal impairment). Albuminuria and renal impairment are the two main manifestations of renal disease in T2D, but not entirely linked in patients with T2D. Resent data suggest that there are distinct pathways to development of non-albuminuric or albuminuric renal impairment. The aim of this study was to identify clinical characteristics associated with non-albuminuric renal impairment in type 2 diabetic patients in a large nation-wide population-based diabetes register. Methods: 62 661 patients with T2D aged 30-80 years with complete datasets reported on albumin excretion, renal function (serum creatinine) and clinical characteristics to the Swedish National Diabetes register; NDR in 2008 were included in the study. Complete datasets were found in 63% of all patients reported to NDR this year. Albuminuria was defined as urinary albumin excretion rate > 20 g/min and renal impairment as estimated glomerular filtration rate; eGFR< 60 ml/min/1.73 m 2 according to MDRD. Logistic regression analyses for clinical and biochemical variables with renal impairment with or without albuminuria as dependent variable were preformed. Adjusted odds ratios were calculated and continuous variables were increased per one standard deviation; SD. Results: 24% of all patients had albuminuria (n=15 039) (68% micro-and 32% macroalbuminuria) and 15% renal impairment (n=9 308). Among patients with renal impairment 56% had non-albuminuric and 42% albuminuric renal impairment. In a multivariate analyses patients with non-albuminuric renal impairment had significantly and independently shorter diabetes duration (adj OR 0.73; 95%CI 0.70-0.76), higher total cholesterol (1.05; 1.01-1.10), lower levels of triglycerides (0.83; 0.80-0.87), lower systolic blood pressure (0.81; 0.78-0.84), better glycemic control (HbA1c%) (0.86; 0.82-0.91), lower BMI (0.88; 0.84-0.93) and were more often female and non-smokers as compared with patients with albuminuric renal impairment. Conclusions: In this population-based nationwide study the majority of patients with type 2 diabetes and renal impairment were non-albuminuric. Distinct sets of risk factors were associated with the presence or absence of albuminuria, patients with non-albuminuric renal impairment having less prominent features of the "metabolic syndrome". This finding could partly be explained by the use of renin angiotensin system inhibitors among non-albuminuric patients but also support the concept of different underlying pathophysiology mechanisms. Development of markers and methods for a more accurate estimation of renal function in T2D patients without albuminuria is important for screening and future treatment of these patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".