Incidence and Associations of Chronic Kidney Disease in Community Participants With Diabetes: A 5-Year Prospective Analysis of the EXTEND45 Study

Abstract

To determine the incidence of and factors associated with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 in people with diabetes. RESEARCH DESIGN AND METHODSWe identified people with diabetes in the EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45), a population-based cohort study (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) that linked the Sax Institute's 45 and Up Study cohort to community laboratory and administrative data in New South Wales, Australia. The study outcome was the first eGFR measurement <60 mL/min/1.73 m 2 recorded during the follow-up period. Participants with eGFR < 60 mL/min/1.73 m 2 at baseline were excluded. We used Poisson regression to estimate the incidence of eGFR <60 mL/min/1.73 m 2 and multivariable Cox regression to examine factors associated with the study outcome. RESULTSOf 9,313 participants with diabetes, 2,106 (22.6%) developed incident eGFR <60 mL/min/1.73 m 2 over a median follow-up time of 5.7 years (interquartile range, 3.0-5.9 years). The eGFR <60 mL/min/1.73 m 2 incidence rate per 100 person-years was 6.0 (95% CI 5.7-6.3) overall, 1.5 (1.3-1.9) in participants aged 45-54 years, 3.7 (3.4-4.0) for 55-64 year olds, 7.6 (7.1-8.1) for 65-74 year olds, 15.0 (13.0-16.0) for 75-84 year olds, and 26.0 (22.0-32.0) for those aged 85 years and over. In a fully adjusted multivariable model incidence was independently associated with age (hazard ratio 1.23 per 5-year increase;

Incidence and predictors of chronic kidney disease in type-II diabetes mellitus patients attending at the Amhara region referral hospitals, Ethiopia: A follow-up study

“…The median occurrence time of CKD among type-II DM patients was 5 years, which is congruent with a study done in North America (4.4 to 4.7years) [ 9 ]. However, it’s deemed to be shorter than the findings of the studies done in the capital of Ethiopia (Addis Ababa) (5.9 years) [ 27 ], the UK (12years) [ 10 ], and Australia (5.7years) [ 16 ]. This could be ascribed to the quality of the service, the patients’ awareness about complications of DM, health-seeking behavior of patients’, their residency (all urban), and self-care practice were better among participants involved in the current study [ 41 ].…”

“…Moreover, the time-to-occurrence of CKD (the time at which patients developed CKD since they diagnosed with type II DM) varies across different studies. The median occurrence time of CKD was around 3.8-12 years worldwide [9,10,16,17]. In Africa, the incidence of CKD is estimated to be between 13.3-25% [18][19][20][21].…”

Epidemiology and resource use in Spanish type 2 diabetes patients without previous cardiorenal disease: CaReMe Spain study

“…Winell [18], in a 1996-2012 study in Finland, found that diabetic patients have a higher incidence rate of HF, with a worse prognosis, than non-diabetic patients. Sukkar [19] studied 9,313 diabetic patients and found that 22.6% developed CKD during a mean follow up of 5.7 years. Advanced age and cardiovascular comorbidity, among other factors, were associated with an increased incidence.…”

Long-term Physical Activity Decreased the Risk of New-onset Hypertension in Type 2 Diabetes Mellitus Patients with Pre-hypertension: A Retrospective Cohort Study

“…The global diabetes prevalence in 2019 was estimated to be 9.3% (463 million people), rising to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045 [1]. Poorly controlled diabetes can mediate multiple organ damage, leading to microvascular and macrovascular complications, including kidney failure, blindness, amputation, and cardiovascular disease (CVDs) [2] [3]. Despite the medical research of diabetes was already mature and the treatment was comprehensive, T2DM remained considered as an incurable disease, and patients with T2DM still suffered high rates of complications.…”