{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:27:19Z","timestamp":1793179639397,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T00:00:00Z","timestamp":1320105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Adults with cystic fibrosis (CF) possess multiple potential risk factors for chronic kidney disease, including CF-related diabetes (CFRD) and lifetime nephrotoxic drug exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether cumulative intravenous (IV) aminoglycoside exposure and CFRD increase the risk of chronic kidney disease in adults with CF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cohort study using adults (\u2265 18 yr) in the CF Foundation registry from 2001\u20132008. Chronic kidney disease (stage 3 or greater) was defined by an estimated glomerular filtration rate of less than 60 ml\/min\/1.73 m2. Time-dependent multivariable Cox proportional hazards models were used to determine whether cumulative number of acute pulmonary exacerbations (surrogate for IV aminoglycoside exposure) and CFRD requiring insulin increase the risk of chronic kidney disease, adjusting for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>The study cohort included 11,912 adults with a median follow-up of 4 years. During the study period, 204 subjects had chronic kidney disease, with an annual disease prevalence of 2.3%. Disease prevalence doubled with every 10-year increase in age. CFRD requiring insulin therapy substantially increased the risk of chronic kidney disease (1\u20134 yr of CFRD requiring insulin vs. no CFRD, hazard ratio [HR] = 2.40, 95% confidence interval [CI] 1.74\u20133.32; \u2265 5 yr, HR = 4.56, 95% CI 2.84\u20137.31). Pulmonary exacerbations did not significantly increase the risk of chronic kidney disease (one to five exacerbations vs. none, HR = 0.79, 95% CI 0.56\u20131.11; six to nine exacerbations, HR = 0.92, 95% CI 0.58\u20131.46; \u2265 10 exacerbations, HR = 1.16, 95% CI 0.75\u20131.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CF-related diabetes is a significant risk factor for chronic kidney disease in adults with CF, but additional studies examining IV aminoglycoside exposure directly are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201105-0932oc","type":"journal-article","created":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T22:59:06Z","timestamp":1311893946000},"page":"1147-1152","source":"Crossref","is-referenced-by-count":89,"title":["Risk Factors for Chronic Kidney Disease in Adults with Cystic Fibrosis"],"prefix":"10.1093","volume":"184","author":[{"given":"Bradley S.","family":"Quon","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington"},{"name":"Division of Respirology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Mayer-Hamblett","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira L.","family":"Aitken","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Smyth","sequence":"additional","affiliation":[{"name":"Child Health and Nottingham Respiratory Biomedical Research Unit, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H.","family":"Goss","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington"},{"name":"Division of Pulmonary Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2011,11,15]]},"reference":[{"key":"2026032101202150300_bib1","article-title":"2009 Annual Data Report","author":"Cystic Fibrosis Foundation Patient Registry","year":"2011"},{"key":"2026032101202150300_bib2","first-page":"F1038","article-title":"Both the wild type and a functional isoform of 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