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. 2017 Dec 18;9(2):2236-2248.
doi: 10.18632/oncotarget.23368. eCollection 2018 Jan 5.

The prevalence and association of chronic kidney disease and diabetes in liver cirrhosis using different estimated glomerular filtration rate equation

Cheng-Yi Chen  1   2   3 , Cheng-Jui Lin  2   4   5 , Chih-Sheng Lin  3 , Fang-Ju Sun  2   6 , Chi-Feng Pan  2   4 , Han-Hsiang Chen  2   4 , Chih-Jen Wu  4   5   7   8
Affiliations

The prevalence and association of chronic kidney disease and diabetes in liver cirrhosis using different estimated glomerular filtration rate equation

Cheng-Yi Chen et al. Oncotarget. .

Abstract

Background: Chronic kidney disease (CKD) in cirrhosis is one of the dreaded complications associated with a steep rise in mortality and morbidity, including diabetes. There are limited data on the prevalence of CKD and the association with diabetes in outpatients with cirrhosis.

Methodology: This is a cross-sectional study of 7,440 adult liver cirrhosis patients enrolled from August 2001 to April 2010 in a medical center. Case control matching by age and sex with 1,967 pairs, and conditional logistic regression for odds of diabetes was analyzed using adjusted model.

Results: CKD was present in 46.0%, 45.7% and 45.6% of the study population using the MDRD-6, CKD-EPI and MDRD-4 estimated glomerular filtration rate (eGFR) equations, respectively. Using a conditional logistic regression model after adjusting for other risk factors, odds for diabetes increased significantly compared with non-CKD in CKD stage 3 to 5 (stage 3~5) based on MDRD-6-adjusted model, ORs were: stage 3~5, 2.34 (95% CI, 1.78-3.01); MDRD-4-adjusted model, ORs were: stage 3~5, 8.51 (95% CI, 5.63-11.4); CKD-EPI-adjusted model, ORs were: stage 3~5, 8.61 (95% CI, 5.13-13.9).

Conclusion: In cirrhosis patients, prevalence of diabetes was higher in patients with advanced stage of CKD. For patients with cirrhosis, patients with CKD stages 3~5 defined by MDRD-4, MDRD-6, and CKD-EPI eGFR equations had increased risk for diabetes. More severe cirrhosis, indicated by the Child-Turcott-Pugh classification was also accompanied by an increased risk for diabetes.

Keywords: MELD score; chronic kidney disease; diabetes mellitus; estimated glomerular filtration rate; liver cirrhosis.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that they have no potential conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1. Prevalence of different CKD stage in MDRD-4, MRDR-6, and CKD-EPI Estimating GFR (eGFR) Equations
Figure 2
Figure 2. Prevalence of diabetics in different group MELD score and CTP classification
Figure 3
Figure 3. Flowchart of selection of study population
See this image and copyright information in PMC

References

    1. Forman LM, Lucey MR. Predicting the prognosis of chronic liver disease: an evolution from child to MELD. Mayo End-stage Liver Disease. Hepatology. 2001;33:473–5. - PubMed
    1. Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D'Amico G, Dickson ER, Kim WR. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–70. - PubMed
    1. Francoz C, Glotz D, Moreau R, Durand F. The evaluation of renal function and disease in patients with cirrhosis. J Hepatol. 2010;52:605–13. - PubMed
    1. Alessandria C, Ozdogan O, Guevara M, Restuccia T, Jimenez W, Arroyo V, Rodes J, Gines P. MELD score and clinical type predict prognosis in hepatorenal syndrome: relevance to liver transplantation. Hepatology. 2005;41:1282–9. - PubMed
    1. Hsu CC, Hwang SJ, Wen CP, Chang HY, Chen T, Shiu RS, Horng SS, Chang YK, Yang WC. High prevalence and low awareness of CKD in Taiwan: a study on the relationship between serum creatinine and awareness from a nationally representative survey. Am J Kidney Dis. 2006;48:727–38. - PubMed