KEEP 2010Comparison of the CKD Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) Study Equations: Prevalence of and Risk Factors for Diabetes Mellitus in CKD in the Kidney Early Evaluation Program (KEEP)
Section snippets
Study Participants
KEEP is a free community-based health screening program targeting individuals 18 years and older with diabetes, hypertension, or a family history of diabetes, hypertension, or kidney disease. We included 123,704 eligible KEEP participants from August 2000 through December 31, 2009, from 48 National Kidney Foundation affiliates and 2,634 screening programs in 50 states and the District of Columbia. We excluded participants who previously had undergone dialysis or kidney transplant or whose
Demographics of the Study Population
For the included 109,055 eligible KEEP participants, demographic, clinical, and laboratory data were collected between August 2000 and December 31, 2009. Mean age was 55.3 ± 0.05 years. Mean body mass index (BMI) was 30.2 ± 0.02 kg/m2. Of the total cohort, 68.2% were women; 31.8% were African American, 49.7% were white, and 11.9% were Hispanic.
Demographics and Prevalence of and Risk Factors for Diabetes
Of 109,055 participants, 34,144 (31.3%) had diabetes. Mean fasting blood glucose level was 94.7 ± 0.1 mg/dL for nondiabetic and 138.5 ± 0.71 mg/dL for
Discussion
Although several studies show a high prevalence of diabetes in patients with advanced CKD (eGFR <60 mL/min/1.73 m2),5, 9, 15 this analysis is among the first to describe a high prevalence of diabetes in earlier stages of CKD using the CKD-EPI equation to estimate GFR. Our data suggest that increases in diabetes prevalence were similar in participants identified with CKD and across stages using the CKD-EPI and MDRD Study equations. Our data further suggest that using the CDK-EPI equation to
Acknowledgements
The KEEP Steering Committee comprises: George Bakris, MD, FACP, FASN; Peter McCullough, MD, MPH; Andrew Bomback, MD; Claudine Jurkovitz, MD, MPH; Bryan Kestenbaum, MD; Louis Kuritzky, MD; Samy McFarlane, MD, MPH, FACP; Rajendra H. Mehta, MD; Keith Norris, MD; Michael Shlipak, MD, MPH; James Sowers, MD; Manjula Kurella Tamura, MD, MPH; Lesley Stevens, MD, MS; Adam Whaley-Connell, DO, MSPH; Ex-Officio: Bryan Becker, MD; Allan Collins, MD, FACP; Andrew Narva, MD, FACP; Nilka Rios Burrows, MPH;
References (43)
- et al.
Global estimates of the prevalence of diabetes for 2010 and 2030
Diabetes Res Clin Pract
(2010) - et al.
CKD and cardiovascular disease in screened high-risk volunteer and general populations: the Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES) 1999-2004
Am J Kidney Dis
(2008) - et al.
Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64)
Kidney Int
(2003) - et al.
Diabetes prevalence and diagnosis in US states: analysis of health surveys
Popul Health Metr
(2009) - et al.
The state of chronic kidney disease, ESRD, and morbidity and mortality in the first year of dialysis
Clin J Am Soc Nephrol
(2009) Temporal trends in the burden of chronic kidney disease in the United States
Curr Opin Nephrol Hypertens
(2010)- et al.
Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association
Circulation
(1999) - et al.
Insulin resistance and cardiovascular disease
J Clin Endocrinol Metab
(2001) - et al.
Diabetes and cardiovascular disease
Diabetes Care
(1999) - et al.
New-onset diabetes after hemodialysis initiation: impact on survival
Am J Nephrol
(2010)
Dysglycemia predicts cardiovascular and kidney disease in the Kidney Early Evaluation Program
J Clin Hypertens (Greenwich)
Executive summary: American Diabetes Associationstandards of medical care in diabetes—2010
Diabetes Care
Standards of medical care in diabetes—2010
Diabetes Care
Strategies to identify adults at high risk for type 2 diabetes: the Diabetes Prevention Program
Diabetes Care
Prevention of type 2 diabetes: an update
Curr Diabetes Rep
New-onset diabetes after transplantation—should it be a factor in choosing an immunosuppressant regimen for kidney transplant recipients
Nephrol Dial Transplant
New-onset diabetes after transplantation in tacrolimus-treated, living kidney transplantation: long-term impact and utility of the pre-transplant OGTT
Int Urol Nephrol
Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients
Clin Transplant
Pre-transplant weight but not weight gain is associated with new-onset diabetes after transplantation: a multi-centre cohort Spanish study
NDT Plus
The combined effect of pre-transplant triglyceride levels and the type of calcineurin inhibitor in predicting the risk of new onset diabetes after renal transplantation
Nephrol Dial Transplant
Using standardized serum creatinine values in the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate
Ann Intern Med
Cited by (27)
Hypouricemia is a risk factor for diabetes in Chinese adults
2022, Obesity MedicineCitation Excerpt :These outcomes remained consistent after adjustment for factors associated with the generation and excretion of uric acid (Maiuolo et al., 2016) including age, serum aspartate transaminase (an indicator of liver function), and serum creatinine (an indicator of kidney function) (Table 3). After further adjustment for risk factors for diabetes (body mass index, hypertension, high-density lipoprotein cholesterol, and triglyceride) (McFarlane et al., 2011), hypouricemia, but not hyperuricemia, was associated with diabetes (Table 3). Similar results were obtained after exclusion of participants with anti-diabetic drugs from the analysis (Table 4).
Both low and high levels of low-density lipoprotein cholesterol are risk factors for diabetes diagnosis in Chinese adults
2022, Diabetes Epidemiology and ManagementDiagnosis Patterns of CKD and Anemia in the Japanese Population
2020, Kidney International ReportsRisk factors for decline in renal function among young adults with type 1 diabetes
2018, Journal of Diabetes and its ComplicationsCitation Excerpt :Due to the multicentre structure, variability in measurements cannot be eliminated completely, although procedures are standardized by guidelines. Rates of renal function might be heterogeneous as a result of different estimation methods used to determine eGFR.38,39 In a previous study among a large diabetic cohort, we showed highest accuracy for the MDRD.4
Development of methods to evaluate nephrological screening and support measures, and lessons learned from the Styrian nephrological screening program “niere.schützen”
2018, Zeitschrift fur Evidenz, Fortbildung und Qualitat im GesundheitswesenContrast-Induced Nephropathy. Definitions, Epidemiology, and Implications
2014, Interventional Cardiology ClinicsCitation Excerpt :In addition to a reduced eGFR, albuminuria, proteinuria, diabetes, heart failure, age older than 75 years, female gender, anemia, and hyperglycemia have all been identified as baseline risk factors for CI-AKI.2,6 Most of these risk factors are simply covariates for more severe baseline CKD or are mathematical elements of the eGFR equation (age, gender, race, serum Cr) preferably calculated using the CKD-EPI equation.7 There are procedural factors that can contribute to risk including the use of high-osmolar contrast, greater contrast volumes, direct injection into the renal arteries or suprarenal aortography, cardiogenic shock, use of intra-aortic balloon counterpulsation (IABP), and transcatheter aortic valve replacement (TAVR).
- ⁎
A list of the KEEP Steering Committee members appears in the Acknowledgements.