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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.

          Electronic supplementary material

          The online version of this article (10.1007/s11357-018-0013-3) contains supplementary material, which is available to authorized users.

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          Author and article information

          Contributors
          02-33668000 , klchien@ntu.edu.tw
          Journal
          GeroScience
          Geroscience
          GeroScience
          Springer International Publishing (Cham )
          2509-2715
          2509-2723
          27 February 2018
          April 2018
          : 40
          : 2
          : 201-217
          Affiliations
          [1 ] ISNI 0000 0004 0572 7815, GRID grid.412094.a, Department of Medicine, , National Taiwan University Hospital BeiHu branch, ; Taipei, Taiwan
          [2 ] ISNI 0000 0004 0572 7815, GRID grid.412094.a, Department of Medicine, , National Taiwan University Hospital Jin-Shan branch, ; New Taipei City, Taiwan
          [3 ] ISNI 0000 0004 0546 0241, GRID grid.19188.39, Graduate Institute of Toxicology, , School of Medicine, National Taiwan University, ; Taipei, Taiwan
          [4 ] ISNI 0000 0004 0572 7815, GRID grid.412094.a, Department of Internal Medicine, , National Taiwan University Hospital and College of Medicine, ; Taipei, Taiwan
          [5 ] ISNI 0000 0004 0572 7815, GRID grid.412094.a, Geriatric and Community Medicine Research Center, , National Taiwan University Hospital BeiHu branch, ; Taipei, Taiwan
          [6 ] ISNI 0000 0004 0546 0241, GRID grid.19188.39, Institute of Epidemiology and Preventive Medicine, , College of Public Health, National Taiwan University, ; NO.17, Xu-Zhou Road, Taipei, 100 Taiwan
          [7 ] ISNI 0000 0004 0604 4784, GRID grid.414746.4, Far-Eastern Memorial Hospital, ; New Taipei City, Taiwan
          Article
          PMC5964062 PMC5964062 5964062 13
          10.1007/s11357-018-0013-3
          5964062
          29488059
          ef3f9942-1819-44ed-86b7-bdcadb2a71ff
          © American Aging Association 2018
          History
          : 11 December 2017
          : 9 February 2018
          Funding
          Funded by: National Taiwan University Hospital BeiHu branch
          Categories
          Original Article
          Custom metadata
          © American Aging Association 2018

          Acute kidney injury,Risk factors,Geriatrics,Diabetes mellitus

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