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ByByMiss Jitjira ChaiyaritMiss Jitjira Chaiyarit
ID: 567110015-4ID: 567110015-4
The association between eGFR The association between eGFR and Hyperosmolar Non-Ketotic and Hyperosmolar Non-Ketotic
Hyperglycemia Syndrome in Hyperglycemia Syndrome in Diabetes type 2Diabetes type 2
Doctoral Seminar 1 / 2013
OutlineOutline
•Introduction
•Materials and Methods
•Results
•Discussion
Doctoral Seminar 1 / 2013
IntroductionIntroduction
Hyperosmolar Non-Ketotic Hyperglycemia Syndrome (HNHS) is a life-threatening complication of uncontrolled diabetes mellitus and often found in patients with type 2 diabetes, is a serious condition
most frequently seen in older persons.
Complications associated with HHNS include severe metabolic disturbances, renal impairment etc. The testing of kidney working is an uncommon complication of HNHS but probably subclinical and thus underestimated.
Doctoral Seminar 1 / 2013
Materials and MethodsMaterials and Methods
The design was Cross-sectional analytical.
The information for analysis was part of DM&HT dataset.
The sampling method was stratified cluster sampling with probability proportional to size hospitals
The exclusion criteria were:i)under age of 18
ii)not been examined serum creatinine
iii)were diagnosed with HT or both DM & HTDoctoral Seminar 1 / 2013
Materials and Methods (Cont.)Materials and Methods (Cont.)
The main outcome was HNHS (yes, no)
The factor of interest was eGFR that was
recalculated by CKD-EPI formulas
Covariate were gender, age, receiving ACEI
or ARB and HbA1CDoctoral Seminar 1 / 2013
Stages of kidney disease eGFRStage 1-2 ≥ 60
Stage 3 30-59
Stage 4-5 ≤ 29
Materials and Methods (Cont.)Materials and Methods (Cont.)
Statistical analysis:
i)The continuous variables were presented
as mean and standard deviation.
ii) The categorical variables were presented
as frequency and percentage.
iii) Logistic regression models were used to
examine association and OR.
Doctoral Seminar 1 / 2013
Materials and Methods (Cont.)Materials and Methods (Cont.)
• Ethical Consideration
The permission to study was granted by each of sampled hospitals. Obtaining written informed consent of all participating patients was done prior to access to their medical records. Data collection was done by participating hospital’s authorized skilled personnel who had been trained to protect and deliberately engaged in the study.
Doctoral Seminar 1 / 2013
Materials and Methods (Cont.)Materials and Methods (Cont.)
Doctoral Seminar 1 / 2013
• Research frame
ResultsResults
Baseline Characteristics
•eGFR (n=24,133)
Doctoral Seminar 1 / 2013
Mean(SD) = 84.22 (24.44)(mL/minute/1.73m2)
Results (Cont.) Results (Cont.)
Baseline Characteristics (Cont.)
Doctoral Seminar 1 / 2013
• Gender (n= 24,263) • Age (n= 24,245)
Mean(SD) = 56.09 (10.90)(year)
Results (Cont.) Results (Cont.)
Baseline Characteristics (Cont.)
Doctoral Seminar 1 / 2013
• Receiving ACEI or ARB (n= 19,162)
• HbA1C (n= 17,653)
Results (Cont.) Results (Cont.)
Factors associated with HNHS
Doctoral Seminar 1 / 2013
Results (Cont.) Results (Cont.)
Factors associated with HNHS adjusted for all other factors
Doctoral Seminar 1 / 2013
DiscussionDiscussion
•The study found statistically significant
association between eGFR and HNHS.
•The present result found the patients with low
eGFR had risk effect (adj.OR=2.89) for having
HNHS. This is consistent with a previous finding
that if renal function declined, it was cause of
glucosuria that was a risk factor for HNHS.
Doctoral Seminar 1 / 2013
Discussion (Cont.)Discussion (Cont.)
•From result, age was protective effect
(adj.OR=0.80) that contrasts with research in the
past which found the average age of patients
with HNHS is 60 years. In the other hand, the
previous research has demonstrated that
HNHS may also occur in younger people.
Doctoral Seminar 1 / 2013
Discussion (Cont.)Discussion (Cont.)
•The patients who had poor glycemic control
(HbA1c ≥ 7%) were at greater risk (adj.OR=2.01).
This finding suggests that in those who have
not been able to control their diabetes, HNHS
will occur. This result supports past studies
show that the patients were poor management
if blood sugar levels rise and left untreated,
this can result in diabetic coma and death.
Doctoral Seminar 1 / 2013
Thank youThank you
for your attention.for your attention.
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