title: Epidemiology of diabetic kidney disease in adult patients with type 1 diabetes in Italy: The AMD-Annals initiative.
abstract: Patients with type 1 diabetes mellitus are at increased risk of death. This risk appears to be modulated by kidney dysfunction. The aim of this study was to evaluate the prevalence of diabetic kidney disease (DKD), its traits, and clinical correlates in a large sample of patients with type 1 diabetes.
  
  
  
  Clinical data of 20 464 patients with type 1 diabetes were extracted from electronic medical records. Estimated glomerular filtration rate (eGFR) and increased urinary albumin excretion were considered.
  
  
  
  Mean age of the patients was 46 ± 16 years, 55.0% were males, and duration of diabetes 19 ± 13 years. The frequency of diabetic kidney disease, low eGFR, and albuminuria was 23.5%, 8.1%, and 19.5%, respectively. In the multivariate analysis the presence of diabetic kidney disease was associated with age (odds ratio [OR] = 1.14, 95% confidence interval [CI]: 1.10-1.18), duration of diabetes (OR = 1.05, 95% CI: 1.03-1.07), and worse glycemic control (OR = 1.24, 95% CI: 1.21-1.28, for every 1% glycated hemoglobin increase). Diabetic kidney disease was also independently associated with an atherogenic lipid profile and increased systolic blood pressure. Glucose control, systolic blood pressure, triglycerides, and high density lipoprotein cholesterol were associated with both low eGFR and albuminuria. Male gender, retinopathy and smoke were related to albuminuria, being female was related to low eGFR, while SUA levels were associated with DKD, low eGFR and albuminuria.
  
  
  
  In our sample of patients with type 1 diabetes, diabetic kidney disease entails an unsafe cardiovascular risk profile. Hyperglycemia, arterial hypertension, and atherogenic lipid profile affected both low eGFR and albuminuria. Retinopathy and smoking were related only to albuminuria while being female and elevated serum uric acid were associated only with low eGFR.
authors.affiliation: Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pacilli
authors.affiliation: Università degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.affiliation: Department of Medicine, University of Padova, Padua, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Fioretto
authors.affiliation: Diabetes and Metabolism Unit, Chieri (TO), Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Giorda
authors.affiliation: Institut d'Investigacions Biomèdiques August Pii Sunyer (IDIBAPS) and Centro de Investigación Biomédicaen Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.|U.O. Diabetologia e Malattie Metaboliche, Multimedica IRCCS, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
authors.affiliation: U.O. Diabetologia e Malattie Metaboliche, Multimedica IRCCS, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Genovese
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Russo
authors.affiliation: Associazione Medici Diabetologi, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Guida
authors.affiliation: Università degli Studi and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontremoli
authors.affiliation: Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Cosmo
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology* / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors
keywords: albuminuria; chronic kidney disease; epidemiology; glomerular filtration rate; type 1 diabetes