Rikke Borg - Profile on Academia.edu (original) (raw)
Papers by Rikke Borg
The Contact System in Chronic Kidney Disease and Hemodialysis – A Cross-Sectional Study
Research Square (Research Square), May 20, 2024
Objectives: To describe the clinical characteristics, comorbidity, and medical treatment in a pri... more Objectives: To describe the clinical characteristics, comorbidity, and medical treatment in a primary care population with chronic kidney disease (CKD). Additionally, to investigate how primary care physicians (PCPs) diagnose, manage and treat impaired kidney function, including uptake of cardio-renoprotective renin-angiotensin-aldosterone system inhibitors (RAASis) and sodium glucose co-transporter 2 inhibitors (SGLT2is). Design: An observational study of CKD prevalence, treatment patterns and comorbidities in primary care based on patient record data combined with a questionnaire on diagnosis, management and treatment of impaired kidney function in a real-world, primary care setting. Setting: 128/211 randomly invited primary care clinics throughout Denmark and a questionnaire completed by 125/128 participating PCPs. Methods: A computerized selection identi ed 12 random individuals with CKD per clinic with ≥2 measurements of eGFR <60 mL/min/1.73 m 2 or UACR >30 mg/g within two years (N=1 497). Prespeci ed data collected from individual electronic health records included demographics, clinical variables, comorbidities, and relevant prescribed medications. Results: Of the CKD study population (N=1 497), 80% had hypertension, 32% diabetes (DM), 13% heart failure (HF), 59% no DM/HF. ACEis/ARBs were prescribed to 65%, statins to 56%, SGTL2is to 14%, and MRAs to 8% of all individuals. Treatment patterns differed between individuals with varying comorbidities, e.g., ACEis/ARBs usage was higher in DM (76%) or HF (74%) vs. no DM/HF (58%), as was statin usage (76% in DM vs. 45% in no DM/HF). SGTL2i usage in no DM/HF was low. Most PCPs identi ed CKD using eGFR <60 mL/min/1.73 m 2 (62%) or UACR >30 mg/g (58%) and 62% reported initiating treatment to retard kidney function decline. Conclusions: Despite good PCP awareness and wish to use relevant guidelines, a gap exists in implementation of cardio-renoprotective treatment, especially in individuals without DM/HF. This offers an opportunity for clear recommendations to PCPs to optimize early cardio-renal protection in individuals with CKD.
Progression to ESKD in Type 1 Diabetes by Histological Findings
Journal of the American Society of Nephrology, Nov 1, 2023
Design and Methodology of the PRIMETIME1 Cohort Study: Precision Medicine Based on Renal Tissue Molecular Interrogation in Diabetic Nephropathy
Journal of the American Society of Nephrology, Nov 1, 2022
Rationale and Design of a Prospective, Clinical Study of Biopsy-Proven Diabetic Nephropathy in People With Type 2 Diabetes: Prevalence and Predictive Factors (The PRIMETIME 2 Study)
Journal of the American Society of Nephrology, Nov 1, 2022
PB0792 Initiation of the Contact Activation System (CAS) and Complement System during Hemodialysis: A Prospective Observational Cohort Study
Research and Practice in Thrombosis and Haemostasis
BMC Primary Care, Jun 21, 2023
Background The prevalence of chronic kidney disease (CKD) is increasing globally. Early diagnosis... more Background The prevalence of chronic kidney disease (CKD) is increasing globally. Early diagnosis in primary care may have a role in ensuring proper intervention. We aimed to determine the prevalence and outcome of CKD in primary care. We performed an observational cohort study in primary care in Copenhagen (2001Copenhagen ( -2015)). Outcomes were stroke, myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), all-cause-and cardiovascular mortality. We combined individuals with normal kidney function and CKD stage 2 as reference. We conducted cause-specific Cox proportional regressions to calculate the hazard ratios for outcomes according to CKD group. We explored the associations between kidney function and the outcomes examined using eGFR as a continuous variable modelled with penalised splines. All models were adjusted for age, gender, diabetes, hypertension, existing CVD, heart failure, LDL cholesterol and use of antihypertensive treatment. We included 171,133 individuals with at least two eGFR measurements of which the majority (n = 157,002) had eGFR > 60 ml/min/1.73m 2 at index date, and 0.05% were in CKD stage 5. Event rates were low in eGFR > 60 ml/min/1.73m 2 but increased in those with higher stages of CKD. In adjusted analyses we observed an increase in hazard rates for every outcome with every increment in CKD stage. Compared to the reference group, individuals in CKD stage 4 had double the hazard rate of PAD, MI, cardiovascular and all-cause mortality. Conclusions Our data from a large primary care cohort demonstrate an early increase in the risk of adverse outcomes already at CKD stage 3. This underlines the importance of studying early intervention in primary care.
Ndt Plus, Jun 24, 2023
Background. Clinical features of diabetic kidney disease alone cannot differentiate between the h... more Background. Clinical features of diabetic kidney disease alone cannot differentiate between the histopathology that defines diabetic nephropathy ( DN ) and non-diabetic nephropathy ( NDN ) . A kidney biopsy is necessary to make the definitive diagnosis of DN. However, there is no consensus on when to perform a kidney biopsy in individuals with diabetes and kidney disease. Furthermore, the implications of NDN versus DN for management, morbidity and kidney prognosis are unclear. To address the gap in knowledge, we aimed to create a national retrospective cohort of people with diabetes and a performed kidney biopsy. Methods. Adults diagnosed with diabetes in Denmark between 1996 and 2020 who had a kidney biopsy performed were included. The cohort was established by linking a nationwide diabetes registry with the Danish Pathology Registry. Data from 11 national registries and databases were compiled. The type of kidney disease was classified using a three-step analysis of Systematized Nomenclature of Medicine codes reported in relation to the histopathological examinations of kidney tissue. The final cohort and classification of kidney disease was as follows: out of 485 989 individuals with diabetes 2586 were included, 2259 of whom had type 2 diabetes. We were able to classify 599 ( 26.5% ) with DN, 703 ( 31.1% ) with NDN and 165 ( 7.3% ) with mixed disease in individuals with type 2 diabetes. In individuals with type 1 diabetes, 132 ( 40.4% ) had DN, 73 ( 22.3% ) NDN and 39 ( 11.9% ) mixed disease. The remaining could not be classified or had normal histology. The overall median ( Q1-Q3 ) follow-up time was 3.8 ( 1.6-7.2 ) years. Conclusions. This cohort is a novel platform based on high-quality registry data for important longitudinal studies of the impact of kidney disease diagnosis on prognosis. With regular updates of data from the Danish registries, the presented follow-up will increase over time and is only limited by emigration or death.
Nephrology Dialysis Transplantation, Jun 1, 2023
Background and Aims: Diabetes and its complications (e.g. chronic kidney disease [CKD] and cardio... more Background and Aims: Diabetes and its complications (e.g. chronic kidney disease [CKD] and cardiovascular disease [CVD]) impose significant clinical and financial burden. Recent large-scale randomized controlled trials have demonstrated cardiorenal benefit of the anti-diabetic drug sodium glucose cotransporter 2 (SGLT2) inhibitors, and they are approved for the treatment of CKD and/or heart failure (HF) in many countries. In the present study, we assessed the economic effectiveness of SGLT2 inhibitors for patients with type 2 diabetes (T2DM) using a cost-analysis model that adopts CKD-dependent increases in the risk of developing CVD. Method: We constructed a natural history model for T2DM patients incorporating CKD, end-stage renal disease, and CVD including myocardial infarction, HF, and stroke as diabetic complications. All diseases except for CKD were considered independent (i.e., the development of CKD increases the risk of CVD manifestation but a patient who develops one disease does not present with another disease). By using a population-based microsimulation, we estimated the 10-year medical costs in Japanese Yen (JPY) and outcomes (development of complications and quality-adjusted life years [QALY]) for patients who initiated antidiabetic therapy with SGLT2 inhibitors or conventional therapy. Probabilistic sensitivity analysis (PSA) was performed with 1,000,000 iterations. Results: The total medical costs per person were JPY 1,193,000 versus JPY 1,160,000 and the QALYs were 8.13 versus 8.02 years for the SGLT2 inhibitor strategy versus the conventional strategy, respectively. As a result, the incremental cost-effectiveness ratio (ICER) was 302,000 JPY/QALY, well below the threshold value of JPY 5,000,000/QALY. The PSA revealed that the probability of ICER being below the threshold was 97.7%. We demonstrated that the use of SGLT2 inhibitors was costeffective compared to the conventional strategy for treating patients with T2DM, and these results suggest clinical and financial benefit of SGLT2 inhibitors that can holistically approach T2DM and its renal and cardiovascular complications.
Rationale and design of a prospective, clinical study of kidney biopsies in people with type 2 diabetes and severely increased albuminuria (the PRIMETIME 2 study)
BMJ Open
IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based ... more IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based on clinical characteristics such as persistently elevated albuminuria, hypertension and decline in kidney function, although this definition is not specific to kidney disease caused by diabetes. The only way to establish an accurate diagnosis—diabetic nephropathy—is by performing a kidney biopsy. The histological presentation of diabetic nephropathy can be associated with a heterogeneous range of histological features with many pathophysiological factors involved demonstrating the complexity of the condition. Current treatment strategies aim to slow disease progression and are not specific to the underlying pathological processes.This study will investigate the prevalence of diabetic nephropathy in individuals with type 2 diabetes (T2D) and severely elevated albuminuria. The deep molecular characterisation of the kidney biopsy and biological specimens may pave the way for improved diagno...
Non-albuminuric chronic kidney disease in diabetes: A different approach?
Indian Journal of Medical Research
Journal of Antimicrobial Chemotherapy
ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin... more ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin or clindamycin is investigated in patients receiving chronic haemodialysis (HD). However, data on plasma concentrations of these antibiotics during HD are sparse. This study aims to determine if the plasma concentration of amoxicillin and clindamycin is sufficient during HD after oral administration of amoxicillin and clindamycin at three different time intervals prior to the HD procedure.MethodsAdult patients receiving chronic HD were investigated twice with an interval of at least 7 days starting with either a tablet of 500/125 mg amoxicillin/clavulanic acid or a tablet of 600 mg clindamycin. Patients were randomized to take the antibiotics either 30, 60 or 120 min prior to the HD procedure. Plasma antibiotic concentrations were measured at start, midway and at the end of HD. A lower threshold was set at 2.0 mg/L for amoxicillin and at 1.0 mg/L for clindamycin. In addition, a populati...
BMJ Open, 2017
The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a ran... more The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a randomised clinical trial (MAGiCAL-CKD): essential study design and rationale. BMJ Open 2017;7:e016795.
International Journal of Nephrology
Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chroni... more Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium–glucose ...
Assessing postprandial hyperglycaemia and glucose variability. The ADAG study
Diabetologia, 2009
MO518: Chronic Kidney Disease in Primary Care and the Risk of Cardiovascular Comorbidity and Mortality
Nephrology Dialysis Transplantation, May 1, 2022
[SGLT2 inhibitorsfor treatment of chronic kidney disease without diabetes or heart failure]
Ugeskrift for Læger, Apr 18, 2022
1,5 AnhydroGlucitol Concentrations and Measures of Glucose Control and Glucose Variability in T1DM and T2DM Patients
Diabetes, 2009
Original Article: Epidemiology Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA 1c
Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose toleran... more Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the WorldHealthOrganizationclassificationorbythenewlyproposedHbA1clevel ‡ 6.5%among6258participantsoftheDanish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7‐4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0‐7.2%) had diabetes by HbA1c levels. HbA1c-defined individuals were relatively older with higher proportions of men, smokers, lipid a...
The Contact System in Chronic Kidney Disease and Hemodialysis – A Cross-Sectional Study
Research Square (Research Square), May 20, 2024
Objectives: To describe the clinical characteristics, comorbidity, and medical treatment in a pri... more Objectives: To describe the clinical characteristics, comorbidity, and medical treatment in a primary care population with chronic kidney disease (CKD). Additionally, to investigate how primary care physicians (PCPs) diagnose, manage and treat impaired kidney function, including uptake of cardio-renoprotective renin-angiotensin-aldosterone system inhibitors (RAASis) and sodium glucose co-transporter 2 inhibitors (SGLT2is). Design: An observational study of CKD prevalence, treatment patterns and comorbidities in primary care based on patient record data combined with a questionnaire on diagnosis, management and treatment of impaired kidney function in a real-world, primary care setting. Setting: 128/211 randomly invited primary care clinics throughout Denmark and a questionnaire completed by 125/128 participating PCPs. Methods: A computerized selection identi ed 12 random individuals with CKD per clinic with ≥2 measurements of eGFR <60 mL/min/1.73 m 2 or UACR >30 mg/g within two years (N=1 497). Prespeci ed data collected from individual electronic health records included demographics, clinical variables, comorbidities, and relevant prescribed medications. Results: Of the CKD study population (N=1 497), 80% had hypertension, 32% diabetes (DM), 13% heart failure (HF), 59% no DM/HF. ACEis/ARBs were prescribed to 65%, statins to 56%, SGTL2is to 14%, and MRAs to 8% of all individuals. Treatment patterns differed between individuals with varying comorbidities, e.g., ACEis/ARBs usage was higher in DM (76%) or HF (74%) vs. no DM/HF (58%), as was statin usage (76% in DM vs. 45% in no DM/HF). SGTL2i usage in no DM/HF was low. Most PCPs identi ed CKD using eGFR <60 mL/min/1.73 m 2 (62%) or UACR >30 mg/g (58%) and 62% reported initiating treatment to retard kidney function decline. Conclusions: Despite good PCP awareness and wish to use relevant guidelines, a gap exists in implementation of cardio-renoprotective treatment, especially in individuals without DM/HF. This offers an opportunity for clear recommendations to PCPs to optimize early cardio-renal protection in individuals with CKD.
Progression to ESKD in Type 1 Diabetes by Histological Findings
Journal of the American Society of Nephrology, Nov 1, 2023
Design and Methodology of the PRIMETIME1 Cohort Study: Precision Medicine Based on Renal Tissue Molecular Interrogation in Diabetic Nephropathy
Journal of the American Society of Nephrology, Nov 1, 2022
Rationale and Design of a Prospective, Clinical Study of Biopsy-Proven Diabetic Nephropathy in People With Type 2 Diabetes: Prevalence and Predictive Factors (The PRIMETIME 2 Study)
Journal of the American Society of Nephrology, Nov 1, 2022
PB0792 Initiation of the Contact Activation System (CAS) and Complement System during Hemodialysis: A Prospective Observational Cohort Study
Research and Practice in Thrombosis and Haemostasis
BMC Primary Care, Jun 21, 2023
Background The prevalence of chronic kidney disease (CKD) is increasing globally. Early diagnosis... more Background The prevalence of chronic kidney disease (CKD) is increasing globally. Early diagnosis in primary care may have a role in ensuring proper intervention. We aimed to determine the prevalence and outcome of CKD in primary care. We performed an observational cohort study in primary care in Copenhagen (2001Copenhagen ( -2015)). Outcomes were stroke, myocardial infarction (MI), heart failure (HF), peripheral artery disease (PAD), all-cause-and cardiovascular mortality. We combined individuals with normal kidney function and CKD stage 2 as reference. We conducted cause-specific Cox proportional regressions to calculate the hazard ratios for outcomes according to CKD group. We explored the associations between kidney function and the outcomes examined using eGFR as a continuous variable modelled with penalised splines. All models were adjusted for age, gender, diabetes, hypertension, existing CVD, heart failure, LDL cholesterol and use of antihypertensive treatment. We included 171,133 individuals with at least two eGFR measurements of which the majority (n = 157,002) had eGFR > 60 ml/min/1.73m 2 at index date, and 0.05% were in CKD stage 5. Event rates were low in eGFR > 60 ml/min/1.73m 2 but increased in those with higher stages of CKD. In adjusted analyses we observed an increase in hazard rates for every outcome with every increment in CKD stage. Compared to the reference group, individuals in CKD stage 4 had double the hazard rate of PAD, MI, cardiovascular and all-cause mortality. Conclusions Our data from a large primary care cohort demonstrate an early increase in the risk of adverse outcomes already at CKD stage 3. This underlines the importance of studying early intervention in primary care.
Ndt Plus, Jun 24, 2023
Background. Clinical features of diabetic kidney disease alone cannot differentiate between the h... more Background. Clinical features of diabetic kidney disease alone cannot differentiate between the histopathology that defines diabetic nephropathy ( DN ) and non-diabetic nephropathy ( NDN ) . A kidney biopsy is necessary to make the definitive diagnosis of DN. However, there is no consensus on when to perform a kidney biopsy in individuals with diabetes and kidney disease. Furthermore, the implications of NDN versus DN for management, morbidity and kidney prognosis are unclear. To address the gap in knowledge, we aimed to create a national retrospective cohort of people with diabetes and a performed kidney biopsy. Methods. Adults diagnosed with diabetes in Denmark between 1996 and 2020 who had a kidney biopsy performed were included. The cohort was established by linking a nationwide diabetes registry with the Danish Pathology Registry. Data from 11 national registries and databases were compiled. The type of kidney disease was classified using a three-step analysis of Systematized Nomenclature of Medicine codes reported in relation to the histopathological examinations of kidney tissue. The final cohort and classification of kidney disease was as follows: out of 485 989 individuals with diabetes 2586 were included, 2259 of whom had type 2 diabetes. We were able to classify 599 ( 26.5% ) with DN, 703 ( 31.1% ) with NDN and 165 ( 7.3% ) with mixed disease in individuals with type 2 diabetes. In individuals with type 1 diabetes, 132 ( 40.4% ) had DN, 73 ( 22.3% ) NDN and 39 ( 11.9% ) mixed disease. The remaining could not be classified or had normal histology. The overall median ( Q1-Q3 ) follow-up time was 3.8 ( 1.6-7.2 ) years. Conclusions. This cohort is a novel platform based on high-quality registry data for important longitudinal studies of the impact of kidney disease diagnosis on prognosis. With regular updates of data from the Danish registries, the presented follow-up will increase over time and is only limited by emigration or death.
Nephrology Dialysis Transplantation, Jun 1, 2023
Background and Aims: Diabetes and its complications (e.g. chronic kidney disease [CKD] and cardio... more Background and Aims: Diabetes and its complications (e.g. chronic kidney disease [CKD] and cardiovascular disease [CVD]) impose significant clinical and financial burden. Recent large-scale randomized controlled trials have demonstrated cardiorenal benefit of the anti-diabetic drug sodium glucose cotransporter 2 (SGLT2) inhibitors, and they are approved for the treatment of CKD and/or heart failure (HF) in many countries. In the present study, we assessed the economic effectiveness of SGLT2 inhibitors for patients with type 2 diabetes (T2DM) using a cost-analysis model that adopts CKD-dependent increases in the risk of developing CVD. Method: We constructed a natural history model for T2DM patients incorporating CKD, end-stage renal disease, and CVD including myocardial infarction, HF, and stroke as diabetic complications. All diseases except for CKD were considered independent (i.e., the development of CKD increases the risk of CVD manifestation but a patient who develops one disease does not present with another disease). By using a population-based microsimulation, we estimated the 10-year medical costs in Japanese Yen (JPY) and outcomes (development of complications and quality-adjusted life years [QALY]) for patients who initiated antidiabetic therapy with SGLT2 inhibitors or conventional therapy. Probabilistic sensitivity analysis (PSA) was performed with 1,000,000 iterations. Results: The total medical costs per person were JPY 1,193,000 versus JPY 1,160,000 and the QALYs were 8.13 versus 8.02 years for the SGLT2 inhibitor strategy versus the conventional strategy, respectively. As a result, the incremental cost-effectiveness ratio (ICER) was 302,000 JPY/QALY, well below the threshold value of JPY 5,000,000/QALY. The PSA revealed that the probability of ICER being below the threshold was 97.7%. We demonstrated that the use of SGLT2 inhibitors was costeffective compared to the conventional strategy for treating patients with T2DM, and these results suggest clinical and financial benefit of SGLT2 inhibitors that can holistically approach T2DM and its renal and cardiovascular complications.
Rationale and design of a prospective, clinical study of kidney biopsies in people with type 2 diabetes and severely increased albuminuria (the PRIMETIME 2 study)
BMJ Open
IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based ... more IntroductionDiabetic kidney disease is a severe complication of diabetes. The diagnosis is based on clinical characteristics such as persistently elevated albuminuria, hypertension and decline in kidney function, although this definition is not specific to kidney disease caused by diabetes. The only way to establish an accurate diagnosis—diabetic nephropathy—is by performing a kidney biopsy. The histological presentation of diabetic nephropathy can be associated with a heterogeneous range of histological features with many pathophysiological factors involved demonstrating the complexity of the condition. Current treatment strategies aim to slow disease progression and are not specific to the underlying pathological processes.This study will investigate the prevalence of diabetic nephropathy in individuals with type 2 diabetes (T2D) and severely elevated albuminuria. The deep molecular characterisation of the kidney biopsy and biological specimens may pave the way for improved diagno...
Non-albuminuric chronic kidney disease in diabetes: A different approach?
Indian Journal of Medical Research
Journal of Antimicrobial Chemotherapy
ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin... more ObjectivesIn the randomized controlled trial PANTHEM, the prophylactic effect of oral amoxicillin or clindamycin is investigated in patients receiving chronic haemodialysis (HD). However, data on plasma concentrations of these antibiotics during HD are sparse. This study aims to determine if the plasma concentration of amoxicillin and clindamycin is sufficient during HD after oral administration of amoxicillin and clindamycin at three different time intervals prior to the HD procedure.MethodsAdult patients receiving chronic HD were investigated twice with an interval of at least 7 days starting with either a tablet of 500/125 mg amoxicillin/clavulanic acid or a tablet of 600 mg clindamycin. Patients were randomized to take the antibiotics either 30, 60 or 120 min prior to the HD procedure. Plasma antibiotic concentrations were measured at start, midway and at the end of HD. A lower threshold was set at 2.0 mg/L for amoxicillin and at 1.0 mg/L for clindamycin. In addition, a populati...
BMJ Open, 2017
The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a ran... more The effect of magnesium supplementation on vascular calcification in chronic kidney disease-a randomised clinical trial (MAGiCAL-CKD): essential study design and rationale. BMJ Open 2017;7:e016795.
International Journal of Nephrology
Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chroni... more Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium–glucose ...
Assessing postprandial hyperglycaemia and glucose variability. The ADAG study
Diabetologia, 2009
MO518: Chronic Kidney Disease in Primary Care and the Risk of Cardiovascular Comorbidity and Mortality
Nephrology Dialysis Transplantation, May 1, 2022
[SGLT2 inhibitorsfor treatment of chronic kidney disease without diabetes or heart failure]
Ugeskrift for Læger, Apr 18, 2022
1,5 AnhydroGlucitol Concentrations and Measures of Glucose Control and Glucose Variability in T1DM and T2DM Patients
Diabetes, 2009
Original Article: Epidemiology Comparing risk profiles of individuals diagnosed with diabetes by OGTT and HbA 1c
Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose toleran... more Aims Glycated haemoglobin (HbA1c) has been proposed as an alternative to the oral glucose tolerance test for diagnosing diabetes. We compared the cardiovascular risk profile of individuals identified by these two alternative methods. Methods We assessed the prevalence of cardiovascular risk factors in individuals with undiagnosed diabetes according to the WorldHealthOrganizationclassificationorbythenewlyproposedHbA1clevel ‡ 6.5%among6258participantsoftheDanish Inter99 study. Receiver operating curve analysis assessed the ability of fasting: 2-h plasma glucose and HbA1c to distinguish between individuals at high and low risk of ischemic heart disease, predicted by the PRECARD program. Results Prevalence of undiagnosed diabetes was 4.1% [95% confidence interval (CI) 3.7‐4.7%] by the current oral glucose tolerance test definition, whereas 6.6% (95% CI 6.0‐7.2%) had diabetes by HbA1c levels. HbA1c-defined individuals were relatively older with higher proportions of men, smokers, lipid a...