Background: The incidence of chronic kidney disease among patients with diabetes mellitus (DM) remains a global concern. Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus. However, no previous meta-analysis has assessed the effects of body mass index (BMI) on adverse kidney events in patients with DM.
Aim: To determine the impact of BMI on adverse kidney events in patients with DM.
Methods: A systematic literature search was performed on the PubMed, ISI Web of Science, Scopus, Ovid, Google Scholar, EMBASE, and BMJ databases. We included trials with the following characteristics: (1) Type of study: Prospective, retrospective, randomized, and non-randomized in design; (2) participants: Restricted to patients with DM aged ≥ 18 years; (3) intervention: No intervention; and (4) kidney adverse events: Onset of diabetic kidney disease [estimated glomerular filtration rate (eGFR) of < 60 mL/min/1.73 m and/or microalbuminuria value of ≥ 30 mg/g Cr], serum creatinine increase of more than double the baseline or end-stage renal disease (eGFR < 15 mL/min/1.73 m or dialysis), or death.
Results: Overall, 11 studies involving 801 patients with DM were included. High BMI (≥ 25 kg/m) was significantly associated with higher blood pressure (BP) [systolic BP by 0.20, 95% confidence interval (CI): 0.15-0.25, < 0.00001; diastolic BP by 0.21 mmHg, 95%CI: 0.04-0.37, = 0.010], serum albumin, triglycerides [standard mean difference (SMD) = 0.35, 95%CI: 0.29-0.41, < 0.00001], low-density lipoprotein (SMD = 0.12, 95%CI: 0.04-0.20, = 0.030), and lower high-density lipoprotein (SMD = -0.36, 95%CI: -0.51 to -0.21, < 0.00001) in patients with DM compared with those with low BMIs (< 25 kg/m). Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI (RR: 1.22, 95%CI: 1.01-1.43, = 0.036).
Conclusion: The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.
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http://dx.doi.org/10.12998/wjcc.v12.i3.538 | DOI Listing |
Urology
December 2024
King's College London, London, United Kingdom; Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom. Electronic address:
Objective: To assess urological complications in patients undergoing total pelvic exenteration (TPE) for locally advanced (LARC) and recurrent rectal cancer (RRC) as publications in this area are limited. Secondary objectives were to assess whether LARC vs RRC or radiation status affected urological outcomes.
Methods: Single-centre, retrospective study of TPE patients between January 2017 and December 2022.
Crit Care
December 2024
Division of Anesthesia, Critical Care, Pain and Emergency Medicine, UR‑UM103 IMAGINE, University of Montpellier, Nimes University Hospital, Nîmes, France.
Background: In septic shock, the classic fluid resuscitation strategy can lead to a potentially harmful positive fluid balance. This multicenter, randomized, single-blind, parallel, controlled pilot study assessed the effectiveness of a restrictive fluid strategy aiming to limit daily volume.
Methods: Patients 18-85 years' old admitted to the ICU department of three French hospitals were eligible for inclusion if they had septic shock and were in the first 24 h of vasopressor infusion.
Curr Probl Cancer
December 2024
Division of Hematology/Oncology, University of California Irvine Health, Orange, CA, USA. Electronic address:
Genitourinary cancers affect over 480,000 patients in the United States annually. While promising therapeutic modalities continue to emerge, notably immune checkpoint inhibitors, molecular targeted therapies, antibody-drug conjugates, and radioligand therapies, these treatments are associated with a spectrum of adverse side-effects, including ophthalmologic toxicities. In this review, we cover the most commonly used antineoplastic agents for the kidneys, bladder, urinary tracts, prostate, testis, and penis, detailing mechanism, indication, and recent trials supporting their use.
View Article and Find Full Text PDFInfection
December 2024
Department I of Internal Medicine, Division of Infectious Diseases, University of Cologne, Cologne, Germany.
Purpose: Patients with vertebral osteomyelitis (VO) and comorbidities, notably chronic kidney disease (CKD), are at risk of early mortality. The aim of this study was to compare characteristics and outcomes of VO patients with an underlying malignancy (ONCO) to VO patients with CKD and VO patients without comorbidities (CONTROL).
Methods: We performed a retrospective analysis of data which was prospectively collected between 2008 and 2020.
Clin Exp Med
December 2024
Department of Medicine, King's College Hospital NHS Foundation Trust, London, UK.
Background: Inhibitors of the renin-angiotensin-aldosterone system (RAAS), such as ACE inhibitors (ACEi), angiotensin-II receptor blockers and mineralocorticoid receptor antagonists, reduce morbidity and mortality in hypertension, congestive heart failure and chronic kidney disease. However, their use can lead to hyperkalaemia. We examined the proportions of RAAS inhibitor (RAASi) reduction or withdrawal, across GFR strata, following hospitalisation and the effect on patient mortality.
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