Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22197
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dc.contributor.authorTorkamani, Niloufar-
dc.contributor.authorChurilov, Leonid-
dc.contributor.authorRobbins, Raymond J-
dc.contributor.authorJerums, George-
dc.contributor.authorBeik, V-
dc.contributor.authorRadcliffe, N-
dc.contributor.authorPatterson, S-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorBurns, James D-
dc.contributor.authorHart, Graeme K-
dc.contributor.authorLam, Que T-
dc.contributor.authorPower, David A-
dc.contributor.authorMacIsaac, Richard J-
dc.contributor.authorJohnson, D F-
dc.contributor.authorZajac, Jeffrey-
dc.contributor.authorEkinci, Elif I-
dc.date2019-10-22-
dc.date.accessioned2019-12-04T04:59:41Z-
dc.date.available2019-12-04T04:59:41Z-
dc.date.issued2019-01-
dc.identifier.citationJournal of Diabetes and Its Complications 2020; 34(1): 107465en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/22197-
dc.description.abstractTo assess the association between glycaemic status prior to the first hospital presentation with developing adverse renal outcomes overtime in patients with multiple hospital re-admissions. A prospective observational cohort study. All inpatients aged ≥54 years admitted between 2013 and 16 to a tertiary hospital. We prospectively measured HbA1c levels in all inpatients aged ≥54 years admitted between 2013 and 16. Diabetes was defined as prior documented diagnosis of diabetes and/or HbA1c ≥6.5% (47·5 mmol/L). Included patients had ≥ two admissions (at least 90 days apart), baseline estimated glomerular filtration rate (eGFR) >30 ml/min/1·73m2 and no history of renal replacement therapy. We assessed several renal outcomes: (a) 50% decline in eGFR; (b) rapid decline in renal function (eGFR decline >5 mL/min/1·73m2/year) and (c) final eGFR<30 ml/min/1·73m2. Of 4126 inpatients with a median follow-up of 465 days (254, 740), 26% had diabetes. The presence of diabetes was associated with higher odds of (a) 50% decline in eGFR (OR = 1·42;95% CI:1·18-1·70;p < 0·001); (b) rapid decline in renal function (OR = 1·40;95%CI:1·20-1·63;p < 0·001), and (c) reaching eGFR<30 ml/min/1.73m2 (OR = 1·25;95%CI:1·03-1·53;p < 0·05). Every 1% (11 mmol/L) increase in baseline HbA1c was associated with significantly greater odds of (a) >50% decline in eGFR (OR = 1·07;95% CI:1·01-1·4;p < 0·05) and (b) rapid decline in renal function (OR = 1·11;95% CI:1·05-1·18;p < 0·001). In patients with ≥two admissions, the presence of diabetes and higher HbA1c levels were strongly and independently associated with adverse renal outcomes at follow up. Such patients are at high risk of relatively rapid deterioration in renal function and a logical target for structured preventive interventions.en_US
dc.language.isoeng-
dc.subjectDiabetesen_US
dc.subjectHospitalised patientsen_US
dc.subjectRenal diseaseen_US
dc.titleDiabetes and higher HbA1c levels are independently associated with adverse renal outcomes in inpatients following multiple hospital admissions.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleJournal of Diabetes and Its Complicationsen_US
dc.identifier.affiliationGeneral Medicineen_US
dc.identifier.affiliationDepartment of Endocrinology and Diabetes, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australiaen_US
dc.identifier.affiliationCentre for Digital Transformation of Health, University of Melbourneen_US
dc.identifier.affiliationDepartment of Medicine, The University of Melbourne, Parkville, Australiaen_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationDepartment of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationEndocrinologyen_US
dc.identifier.affiliationAdministrative Informatics, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationSchool of Engineering, RMIT University, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationClinical Informatics Unit, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationPathologyen_US
dc.identifier.affiliationNephrologyen_US
dc.identifier.affiliationClinical Analytics and Reportingen_US
dc.identifier.doi10.1016/j.jdiacomp.2019.107465en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0003-3983-0581en_US
dc.identifier.orcid0000-0003-3933-5708en_US
dc.identifier.orcid0000-0003-2372-395Xen_US
dc.identifier.pubmedid31735639-
dc.type.austinJournal Article-
local.name.researcherBellomo, Rinaldo
item.languageiso639-1en-
item.cerifentitytypePublications-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
crisitem.author.deptEndocrinology-
crisitem.author.deptMedicine (University of Melbourne)-
crisitem.author.deptThe Florey Institute of Neuroscience and Mental Health-
crisitem.author.deptClinical Analytics and Reporting-
crisitem.author.deptEndocrinology-
crisitem.author.deptMedicine (University of Melbourne)-
crisitem.author.deptGastroenterology and Hepatology-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
crisitem.author.deptIntensive Care-
crisitem.author.deptPathology-
crisitem.author.deptMedicine (University of Melbourne)-
crisitem.author.deptInstitute for Breathing and Sleep-
crisitem.author.deptEndocrinology-
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