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Instituto Nacional de Salud Pública

2025, Number 1

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salud publica mex 2025; 67 (1)

Premature mortality in individuals living with type 2 diabetes in Jalisco, Mexico, 2011-2019

Palacio-Mejía LS, Álvarez-Aceves M, Ramírez-Knape N, Guzmán-Sandoval L, Mejía-Arias MA, Morales-Carmona E, Espín-Arellano LI, Tamayo-Ortiz M, Tamayo-Orozco JA, Lastiri-Quirós HS, Hernández-Ávila M, Hernández-Ávila JE

Language: English
References: 31
Page: 8-19
PDF size: 420.67 Kb.


ABSTRACT

Objective. To estimate survival outcomes in a population living with diabetes, screened for chronic kidney disease (CKD) and to describe characteristics associated with premature mortality using data from an administrative cohort in Jalisco, Mexico. Materials and methods. Using and administrative cohort design, we investigated the 8-year cumulative mortality associated with CKD. We linked screening with mortality data and described population characteristics by CKD stage, computed years of life lost (YLL), and performed Kaplan-Meier curves and Cox proportional hazard models to analyze survival and mortality risk factors. Results. At screening, 44% of the cohort exhibited impaired renal function. The mortality rate stood at 14%, 2.5% linked to CKD; 8.7% were premature deaths, accumulating 8 036 YLL. Eight-year survival was 93% for individuals with normal renal function at screening, decreasing to 41% for those with glomerular filtration rate below 30 mL/min/1.73m². Albumincreatinine ratio ›300 mg/dl, increased years since diabetes diagnosis, hypertension, amputations, retinopathy, and smoking were associated with higher mortality risk; female sex and obesity with a lower risk. Conclusion. The high prevalence of renal impairment in this cohort and its association with high mortality underscores the critical importance of timely detection and protocolized intervention for CKD to mitigate this burden.


REFERENCES

  1. Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al.Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study2017. Lancet. 2020;395(10225):709-33. https://doi.org/10.1016/S0140-6736(20)30045-3

  2. Institute for Health Metrics and Evaluation. GBD Compare. Seattle:University of Washington, 2019 [cited Jan 8, 2023]. Available from: https://vizhub.healthdata.org/gbd-compare/

  3. Obrador GT, García-García G, Villa AR, Rubilar X, Olvera N, Ferreira E,et al. Prevalence of chronic kidney disease in the Kidney Early EvaluationProgram (KEEP) México and comparison with KEEP US. Kidney Int.2010;77(Suppl 116):S2-8. https://doi.org/10.1038/ki.2009.540

  4. Rojas-Martínez R, Escamilla-Nuñez C, Aguilar-Salinas CA, Castro-PorrasL, Romero-Martínez M, Lazcano-Ponce E. Trends in the mortality ofdiabetes in Mexico from 1998 to 2022: a joinpoint regression and ageperiod-cohort effect analysis. Public Health. 2024;226:128-37. https://doi.org/10.1016/j.puhe.2023.10.038

  5. Agudelo-Botero M, Valdez-Ortiz R, Giraldo-Rodríguez L, González-RobledoMC, Mino-León D, Rosales-Herrera MF, et al. Overview of the burdenof chronic kidney disease in Mexico: Secondary data analysis based onthe Global Burden of Disease Study 2017. BMJ Open. 2020;10(3):e035285.https://doi.org/10.1136/bmjopen-2019-035285

  6. Rios P, Silvariño R, Sola L, Ferreiro A, Lamadrid V, Fajardo L, et al. Mineraland bone disorder and longterm survival in a chronic kidney diseasegrade 3b-4cohort. Ren Fail. 2022;44(1):1357-68. https://doi.org/10.1080/0886022X.2022.2107543

  7. Afkarian M, Sachs MC, Kestenbaum B, Hirsch IB, Tuttle KR, HimmelfarbJ, et al. Kidney disease and increased mortality risk in type 2diabetes. J Am Soc Nephrol. 2013;24(2):302-8. https://doi.org/10.1681/ASN.2012070718

  8. Correa-Rotter R, González-Michaca L. Early detection and preventionof diabetic nephropathy: A challenge calling for mandatory action forMexico and the developing world. Kidney Int. 2005;68(Suppl 98):S69-75.https://doi.org/10.1111/j.1523-1755.2005.09813.x

  9. Quezada-Sánchez AD, Espín-Arellano I, Morales-Carmona E, Molina-Vélez D, Palacio-Mejía LS, González-González EL, et al. Implementationand validation of a probabilistic linkage method for population databaseswithout identification variables. Heliyon. 2022;8(12):e12311. https://doi.org/10.1016/j.heliyon.2022.e12311

  10. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud yNutrición 2012. Resultados por entidad federativa, Jalisco. Cuernavaca:INSP, 2013 [cited Feb 20, 2023]. Available from: https://encuestas.insp.mx

  11. Palacio-Mejía LS, Álvarez M, Ramírez-Knape N, Guzmán-Sandoval L,Mejía-Arias MÁ, Morales-Carmona E, et al. Premature mortality in anadministrative cohort of individuals living with type 2 diabetes screenedfor chronic kidney disease in Jalisco, Mexico 2011-2019. Evidence froma death registry analysis. Supplementary material. Mendeley Data, 2024.https://doi.org/10.17632/4rd32h7c5s.1

  12. Secretaría de Salud. Subsistema epidemiológico y estadístico de defunciones.Mexico City: Dirección General de Información en Salud [citedMar 27, 2023]. Available from: http://www.dgis.salud.gob.mx/contenidos/sinais/s_seed.html

  13. Kidney Disease: Improving Global Outcomes Diabetes Work Group.KDIGO 2020 Clinical Practice Guideline for Diabetes Management inChronic Kidney Disease. Kidney Int. 2020;98(4S):S1-115. https://doi.org/10.1016/j.kint.2020.06.019

  14. Global Burden of Disease Collaborative Network. Global Burden ofDisease (GBD) data and tools guide. Seattle: University of Washington,2020 [cited Oct 3, 2023]. Available from: https://www.healthdata.org/research-analysis/about-gbd/gbd-data-and-tools-guide

  15. Organization for Economic Co-operation and Development. OECDHealth Statistics 2023 Definitions, Sources and Methods Potential years oflife lost by ICD categories. Paris: OECD, 2023 [cited Oct 19, 2023]. Availablefrom: https://www.oecd.org/health/health-data.htm

  16. World Health Organization. The global health observatory. Years oflife lost from mortality (YLL). Geneva: WHO, 2023 [cited Oct 1, 2023].Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/159#

  17. Secretaría de Gobernación. Informa Conapo sobre la esperanza devida de la población mexicana. Boletín No. 295. Mexico City: Gobierno deMéxico, 2019 [cited Mar 21, 2023]. Available from: https://www.gob.mx/segob/prensa/informa-conapo-sobre-la-esperanza-de-vida-de-la-poblacionmexicana?idiom=es

  18. Grambsch PM, Therneau TM. Proportional hazards tests and diagnosticsbased on weighted residuals. Biometrika. 1994;81(3):515-26. https://doi.org/10.1093/biomet/81.3.515

  19. Griffith DM, Sharma G, Holliday CS, Enyia OK, Valliere M, Semlow AR,et al. Men and COVID-19: A biopsychosocial approach to understandingsex differences in mortality and recommendations for practice and policyinterventions. Prev Chronic Dis. 2020;17:200247. https://doi.org/10.5888/pcd17.200247

  20. Hockham C, Schanschieff F, Woodward M. Sex differences in CKDassociatedmortality from 1990 to 2019: Data From the Global Burden ofDisease Study. Kidney Med. 2022;4(10):100535. https://doi.org/10.1016/j.xkme.2022.100535

  21. Fraser SDS, Roderick PJ, May CR, McIntyre N, McIntyre C, Fluck RJ, etal. The burden of comorbidity in people with chronic kidney disease stage3: A cohort study. BMC Nephrol. 2015;16(1):193. https://doi.org/10.1186/s12882-015-0189-z

  22. Shamah-Levy T, Romero-Martínez M, Barrientos-Gutiérrez T, Cuevas-Nasu L, Bautista-Arredondo S, Colchero MA, et al. Encuesta Nacional deSalud y Nutrición 2020 sobre Covid-19. Resultados nacionales. Cuernavaca:Instituto Nacional de Salud Pública, 2021 [cited Feb 9, 2022]. Availablefrom: https://ensanut.insp.mx/encuestas/ensanutcontinua2020/doctos/informes/ensanutCovid19ResultadosNacionales.pdf

  23. Kovesdy CP, Furth S, Zoccali C. World Kidney Day. Obesity andkidney disease: Hidden consequences of the epidemic. Indian J Nephrol.2017;27(2):85-92. https://doi.org/10.4103/ijn.IJN_61_17

  24. Pinto-Sietsma SJ, Navis G, Janssen WMT, de Zeeuw D, Gans ROB, deJong PE. A central body fat distribution is related to renal function impairment,even in lean subjects. Am J Kidney Dis. 2003;41(4):733-41. https://doi.org/10.1016/S0272-6386(03)00020-9

  25. Ladhani M, Craig JC, Irving M, Clayton PA, Wong G. Obesity andthe risk of cardiovascular and all-cause mortality in chronic kidneydisease: a systematic review and meta-analysis. Nephrol Dial Transplant.2017;32(3):439-49. https://doi.org/10.1093/ndt/gfw075

  26. Hannedouche T, Rossignol P, Darmon P, Halimi JM, Vuattoux P, HagegeA, et al. Early diagnosis of chronic kidney disease in patients with diabetesin France: multidisciplinary expert opinion, prevention value and practicalrecommendations. Postgrad Med. 2023;135(7):633-45. https://doi.org/10.1080/00325481.2023.2256208

  27. Shlipak MG, Tummalapalli SL, Boulware LE, Grams ME, Ix JH, Jha V, etal. The case for early identification and intervention of chronic kidneydisease: conclusions from a Kidney Disease: Improving Global Outcomes(KDIGO) Controversies Conference. Kidney Int. 2021;99(1):34-47.https://doi.org/10.1016/j.kint.2020.10.012

  28. Tonelli M, Tiv S, Anand S, Mohan D, García-García G, Gutiérrez-Padilla JA, etal. Diagnostic yield of population-based screening for chronic kidney diseasein low-income, middle-income, and high-income countries. JAMA Netw Open.2021;4(10):e2127396. https://doi.org/10.1001/jamanetworkopen.2021.27396

  29. George C, Echouffo-Tcheugui JB, Jaar BG, Okpechi IG, Kengne AP.The need for screening, early diagnosis, and prediction of chronic kidneydisease in people with diabetes in low- and middle-income countries–areview of the current literature. BMC Med. 2022;20(1):247. https://doi.org/10.1186/s12916-022-02438-6

  30. Rossing P, Caramori ML, Chan JCN, Heerspink HJL, Hurst C, Khunti K,et al. Executive summary of the KDIGO 2022 Clinical Practice Guidelinefor Diabetes Management in Chronic Kidney Disease: an update based onrapidly emerging new evidence. Kidney Int. 2022;102(5):990-9. https://doi.org/10.1016/j.kint.2022.06.013

  31. Instituto Mexicano del Seguro Social. Informe al Ejecutivo Federal yal Congreso de la Unión sobre la situación financiera y los riesgos delInstituto Mexicano del Seguro Social 2021-2022. Mexico City: IMSS, 2022[cited Feb 27, 2023]. Available from: https://www.imss.gob.mx/conoce-alimss/informe-2021-2022




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