Abstract
BACKGROUND: Dysglycemia, including prediabetes and type 2 diabetes (T2DM), is associated with an increased risk of chronic kidney disease and mortality. However, data on the relationship between estimated glomerular filtration rate (eGFR) and all-cause mortality in dysglycemic individuals remain limited. METHODS: This 10-year retrospective cohort study included 277 individuals with dysglycemia from a health check-up clinic at Srinagarind Hospital, Thailand (2007-2017). Participants were divided into three eGFR groups: ≥90, 60-<90, and <60 mL/min/1.73 m(2). Multivariate Cox regression models adjusted for fasting plasma glucose, body mass index, total cholesterol, and hypertension were used to estimate hazard ratios (HRs) for all-cause mortality. The association between ≥40% eGFR decline and mortality was also evaluated. RESULTS: Over 10 years, 37 participants (13.4%) died. Lower eGFR was associated with higher mortality risk. Compared to the ≥90 group, adjusted HRs for all-cause mortality were 1.70 (95% CI 0.82-3.52) for eGFR 60-<90 and 3.74 (95% CI 1.27-11.03) for eGFR <60. A ≥40% eGFR decline significantly increased mortality risk (adjusted HR 7.14; 95% CI 3.16-16.14). CONCLUSION: Dysglycemic individuals with eGFR <60 or a ≥40% eGFR decline have a significantly higher mortality risk, highlighting the need for early detection and intervention.