Abstract
Background
A hyperglycemic crisis episode (HCE) is associated with poor management of diabetes,
which is a risk factor for end-stage renal disease (ESRD); however, the association
between an HCE and ESRD has not been clarified. We conducted a nationwide population-based
cohort study with the purpose of delineating this issue.
Methods
We identified 9208 diabetic patients with an HCE and an identical number of diabetic
patients with matched age, sex, and index date without an HCE between 2000 and 2002.
A comparison of the risk of ESRD between the diabetic patients with and without an
HCE was achieved by a follow-up until 2014.
Results
A Cox proportional hazard regression analysis showed that the diabetic patients with
an HCE were at a higher risk of ESRD than those without an HCE (the adjusted hazard
ratio [AHR]: 1.47; 95% confidence interval [CI]: 1.34–1.62) by adjusting for renal
disease, hypertension, hyperlipidemia, coronary artery disease, hyperuricemia, anemia,
chronic obstructive pulmonary disease, liver disease, malignancy, connective tissue
disease, non-steroid anti-inflammatory drug use, and monthly income. The increased
risk of ESRD was more prominent in the age subgroup of 15–25 years (AHR: 4.91; 95%
CI: 1.92–12.56); 25–35 years (AHR: 2.42; 95% CI: 1.51–3.86); 35–45 years (AHR: 3.01;
95% CI: 2.21–4.09); and 45–55 years (AHR: 1.75; 95% CI: 1.41–2.19).
Conclusions
An HCE was associated with an increased risk of ESRD, especially in the younger diabetic
patients (15–55 years). A close follow-up for the control of diabetes and for monitoring
renal function is proposed.
Keywords
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Article info
Publication history
Published online: February 03, 2018
Accepted:
January 15,
2018
Received in revised form:
December 23,
2017
Received:
September 1,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
