Patients suffering from chronic kidney disease (CKD) show a reduction in kidney functionality. Uncontrolled diabetes is among the causes of CKD. As patients with diabetes attend periodic visits, relevant amounts of data end up being available within EHR systems. This information could be exploited to extract insights into disease progression and provide clinicians with tools to better understand the expected disease course. In this work, we applied multi-trajectory group-based trajectory models (GBTM) to identify and characterize groups of patients with similar progression patterns of CKD and diabetes. Specifically, we studied a population of 7,000 patients with diabetes and an initial diagnosis of CKD stage III followed at diabetes outpatient clinics spread across the Veneto Region (Italy). GBTM analysis led to the identification of 6 unique groups of patients with differing CKD and diabetes progression trajectories. Our results suggest that multi-trajectory modeling via GBTM can shed light on the progression of CKD and its interaction with glycemic control, as well as provide clinicians with tools to preemptively identify patients expected to experience significant CKD worsening.
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http://dx.doi.org/10.1109/EMBC53108.2024.10781792 | DOI Listing |
JAMA Cardiol
March 2025
Stanford University School of Medicine, Stanford University, Stanford, California.
Importance: Outcomes in patients with diabetes after fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) using current-generation drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) are unknown.
Objectives: To investigate the relative treatment effect of PCI vs CABG according to diabetes status with respect to major adverse cardiac and cerebrovascular events (MACCE) at 3 years and to evaluate the impact of the SYNTAX score.
Design, Setting, And Participants: This is a prespecified subgroup analysis of the FAME (Fractional Flow Reserve vs Angiography for Multivessel Evaluation) 3 trial, an investigator-initiated, randomized clinical trial conducted at 48 centers worldwide.
Health Expect
April 2025
Department of Psychology, University of Limerick, Limerick, Ireland.
Background: Experience-Based Co-Design (EBCD) is a popular collaborative process where service users and healthcare providers share their experiences of using and delivering services to identify ways to adapt services to enhance those experiences.
Objective: This study aimed to identify enablers and barriers to the successful implementation of EBCD as part of Ireland's recently adopted Enhanced Community Care (ECC) programme.
Design: Service users and staff at two sites (N = 17) participated in an accelerated EBCD process designed to enhance service provision for older people and those living with chronic conditions.
Liver Int
April 2025
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease globally. MASLD is a multisystem disease where metabolic dysfunction plays a key role in the development of MASLD and its most relevant liver-related morbidities and extrahepatic complications, such as cardiovascular disease, chronic kidney disease and certain types of extrahepatic cancers. Among the least examined MASLD-related extrahepatic complications, an ever-increasing number of observational studies have reported a positive association between MASLD and the risk of serious bacterial infections (SBI) requiring hospital admission.
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March 2025
New Drug Development Center, Daegu-Gyeongbukk Medical Innovation Foundation (K-MEDI hub), 80 Cheombok-ro, Dong-gu, Daegu 41061, Republic of Korea.
Diabetic retinopathy (DR) is one of the most prevalent complications of diabetes, affecting nearly one-third of patients with diabetes mellitus and remaining a leading cause of blindness worldwide. Among the various diabetes-induced complications, DR is of particular importance due to its direct impact on vision and the irreversible damage to the retina. DR is characterized by multiple pathological processes, primarily a hyperglycemia-induced inflammatory response and oxidative stress.
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March 2025
Department of Pathology, Hebei Medical University, Shijiazhuang 050017, China.
Diabetic kidney disease (DKD) is a prevalent complication associated with diabetes in which podocyte dysfunction significantly contributes to the development and progression of the condition. Ring finger protein 183 (RNF183) is an ER-localized, transmembrane ring finger protein with classical E3 ligase activity. However, whether RNF183 is involved in glomerular podocyte dysfunction, which is the mechanism of action of DKD, is still poorly understood.
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