{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:59:18Z","timestamp":1788274758098,"version":"build-2803163510"},"reference-count":35,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["Centre for Excellence Award"],"award-info":[{"award-number":["Centre for Excellence Award"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/18\/2\/34213"],"award-info":[{"award-number":["RE\/18\/2\/34213"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000380","name":"Guy\u2019s and St Thomas Charity","doi-asserted-by":"crossref","award":["JJ180101"],"award-info":[{"award-number":["JJ180101"]}],"id":[{"id":"10.13039\/501100000380","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,7,31]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      We aim to evaluate estimated glomerular filtration rate (eGFR) patterns of progression in a multiethnic cohort of people with type I diabetes mellitus and with baseline eGFR \u226545\u2009mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>People with a clinical diagnosis of type 1 diabetes, attending two university hospital-based outpatient diabetes clinics, in South London between 2004 and 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We studied 1495 participants (52% females, 81% white, 12% African-Caribbean and 7% others).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Clinical measures including weight and height, systolic blood pressure, diastolic blood pressure and laboratory results (such as serum creatinine, urine albumin to creatinine ratio (ACR), HbA1c were collected from electronic health records (EHRs) and eGFR was estimated by the Chronic Kidney Disease\u2013Epidemiology Collaboration. Ethnicity was self-reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five predominantly linear patterns\/groups of eGFR trajectories were identified. Group I (8.5%) had a fast eGFR decline (&gt;3\u2009mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      year). Group II (23%) stable eGFR, group III (29.8%), groups IV (26.3%) and V (12.4%) have preserved eGFR with no significant fall. Group I had the highest proportion (27.6%) of African-Caribbeans. Significant differences between group I and the other groups were observed in age, gender, HbA1C, systolic and diastolic blood pressure, body mass index, cholesterol and urine ACR, p&lt;0.05 for all. At 10 years of follow-up, 33% of group I had eGFR &lt;30 and 16.5%&lt;15 (mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Distinct trajectories of eGFR were observed in people with type 1 diabetes. The group with the highest risk of eGFR decline had a greater proportion of African-Caribbeans compared with others and has higher prevalence of traditional modifiable risk factors for kidney disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083186","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T01:52:17Z","timestamp":1726019537000},"page":"e083186","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Ten years trajectories of estimated glomerular filtration rate (eGFR) in a multiethnic cohort of people with type 1 diabetes and preserved renal function"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0449-869X","authenticated-orcid":false,"given":"Salma","family":"Ayis","sequence":"first","affiliation":[{"name":"Population Health Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios","family":"Mangelis","sequence":"additional","affiliation":[{"name":"Population Health Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Fountoulakis","sequence":"additional","affiliation":[{"name":"King\u2019s Health Partners and School of Cardiovascular Medicine & Sciences, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Collins","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Trust, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamer S","family":"Alobaid","sequence":"additional","affiliation":[{"name":"Population Health Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Gnudi","sequence":"additional","affiliation":[{"name":"King\u2019s Health Partners and King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular & Metabolic Medicine and Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hopkins","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust \/ King's Health Partners, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashanth","family":"Vas","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology, King's College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Thomas","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas' NHS Trust, King\u2019s Health Partners, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aicha","family":"Goubar","sequence":"additional","affiliation":[{"name":"Population Health Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaka","family":"Karalliedde","sequence":"additional","affiliation":[{"name":"King\u2019s Health Partners and King's College London British Heart Foundation Centre of Excellence, School of Cardiovascular & Metabolic Medicine and Sciences, King's College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"2025120523472882000_14.9.e083186.1","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S2213-8587(22)00218-2","article-title":"Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study","volume":"10","author":"Gregory","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025120523472882000_14.9.e083186.2","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/S2213-8587(22)00132-2","article-title":"The uncomfortable truth about kidney disease in type 1 diabetes","volume":"10","author":"Perkins","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025120523472882000_14.9.e083186.3","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1369"},{"key":"2025120523472882000_14.9.e083186.4","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0184"},{"key":"2025120523472882000_14.9.e083186.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.10.046"},{"key":"2025120523472882000_14.9.e083186.6","doi-asserted-by":"crossref","first-page":"107875","DOI":"10.1016\/j.jdiacomp.2021.107875","article-title":"Non-linear renal function decline is frequent in patients with type 2 diabetes who progress fast to end-stage renal disease and is associated with African-Caribbean ethnicity and HbA1c variability","volume":"35","author":"Stoilov","year":"2021","journal-title":"J Diabetes Complicat"},{"key":"2025120523472882000_14.9.e083186.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000091586.46532.B4"},{"key":"2025120523472882000_14.9.e083186.8","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005111200"},{"key":"2025120523472882000_14.9.e083186.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000026493.18542.6A"},{"key":"2025120523472882000_14.9.e083186.10","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.2337\/dc22-0815","article-title":"African Caribbean Ethnicity Is an Independent Predictor of Significant Decline in Kidney Function in People With Type 1 Diabetes","volume":"45","author":"Mangelis","year":"2022","journal-title":"Diabetes Care"},{"key":"2025120523472882000_14.9.e083186.11","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8624.00086"},{"key":"2025120523472882000_14.9.e083186.12","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131413"},{"key":"2025120523472882000_14.9.e083186.13","doi-asserted-by":"publisher","DOI":"10.1177\/0049124106292292"},{"key":"2025120523472882000_14.9.e083186.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2000.tb02070.x"},{"key":"2025120523472882000_14.9.e083186.15","doi-asserted-by":"publisher","DOI":"10.1007\/BF01246098"},{"key":"2025120523472882000_14.9.e083186.16","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780070131"},{"key":"2025120523472882000_14.9.e083186.17","doi-asserted-by":"publisher","DOI":"10.1177\/0049124113503141"},{"key":"2025120523472882000_14.9.e083186.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1977.tb01600.x"},{"key":"2025120523472882000_14.9.e083186.19","unstructured":"StataCorp L . Stata Statistical Software: Release 15 College Station, TX, 2017. College Station, TX, 2017."},{"key":"2025120523472882000_14.9.e083186.20","doi-asserted-by":"publisher","DOI":"10.1177\/0095798420930932"},{"key":"2025120523472882000_14.9.e083186.21","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.189"},{"key":"2025120523472882000_14.9.e083186.22","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-8-199304150-00001"},{"key":"2025120523472882000_14.9.e083186.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0081835","article-title":"Renal function can improve at any stage of chronic kidney disease","volume":"8","author":"Weis","year":"2013","journal-title":"PLoS One"},{"key":"2025120523472882000_14.9.e083186.24","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1997.260"},{"key":"2025120523472882000_14.9.e083186.25","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-023-48427-4","article-title":"Comparative effectiveness of first-line antihypertensive drug classes on the maintenance of estimated glomerular filtration rate (eGFR) in real world primary care","volume":"13","author":"Gao","year":"2023","journal-title":"Sci Rep"},{"key":"2025120523472882000_14.9.e083186.26","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-008-9360-9"},{"key":"2025120523472882000_14.9.e083186.27","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-2062"},{"key":"2025120523472882000_14.9.e083186.28","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1001982"},{"key":"2025120523472882000_14.9.e083186.29","doi-asserted-by":"publisher","DOI":"10.1053\/j.arrt.2003.10.006"},{"key":"2025120523472882000_14.9.e083186.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.01.010"},{"key":"2025120523472882000_14.9.e083186.31","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2018.1851","article-title":"Association of Race and Ethnicity With Glycemic Control and Hemoglobin A1c Levels in Youth With Type 1 Diabetes","volume":"1","author":"Kahkoska","year":"2018","journal-title":"JAMA Netw Open"},{"key":"2025120523472882000_14.9.e083186.32","doi-asserted-by":"publisher","DOI":"10.1207\/s15327906mbr3203_3"},{"key":"2025120523472882000_14.9.e083186.33","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0277"},{"key":"2025120523472882000_14.9.e083186.34","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1111\/pedi.12907","article-title":"Five heterogeneous HbA1c trajectories from childhood to adulthood in youth with type 1 diabetes from three different continents: A group-based modeling approach","volume":"20","author":"Clements","year":"2019","journal-title":"Pediatr Diabetes"},{"key":"2025120523472882000_14.9.e083186.35","doi-asserted-by":"publisher","DOI":"10.1136\/jim-2017-000627"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-083186","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:47:42Z","timestamp":1765007262000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-083186"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9,10]]},"published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1136\/bmjopen-2023-083186"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-083186","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}