This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/ min/1.73 m 2 . Prevalence with confidence intervals across CKD advanced stages 3-5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9-27.0), with severities of 11.4% (9.7-13.4), 6.8% (5.5-8.5), 4.6% (3.5-6.0), and 1.6% (1.0-2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7-70.1) and 38.6% (34.3-43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.Globally, the total number of people with diabetes is estimated to increase from 415 million (8.8%) in 2015 to 642 million (10.4%) in 2040, with the largest alterations expected to occur in the urban population of low-to middle-income countries (LMICs) 1 . Of them, type 2 diabetes mellitus (T2DM) accounts for more than 90% of people with diabetes 2,3 . By 2040, the difference worldwide is projected to broaden, with 477.9 million affected people living in urban areas and 163.9 million in rural areas 1 . It has been postulated that the burden of diabetes and its complications in the LMICs may be contributed by the economic development and rapid urbanisation via increased caloric intake and the adoption of a sedentary lifestyle 2,4,5 . More importantly, the most striking demographic change to diabetes prevalence in global terms also seems to be related to the growth of the proportion of the elderly population 6 .Despite rates of diabetes-related complications such as cardiovascular disease decreasing significantly in the past two decades, it has not translated nearly as well as kidney complications 7 . Approximately 10% of deaths in people with T2DM are attributable to kidney failure 8 . It is well-established that diabetes-related chronic kidney disease (CKD) is the leading cause of end-stage kidney disease (ESKD) in T2DM patients worldwide 9,10 . In the United States, 2013-2016, approximately 36% of patients with diabetes develop diabetic kidney disease resulting in persistent albuminuria, a reduced estimated glomerular filtration rate (eGFR), or both 11 . Interestingly, the risk of diabetes-related CKD is observed much higher in Asian countries than ...
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