Prevalence of Chronic Kidney Disease in Patients with Diabetes in Extremadura (Spain) during the Years 2012, 2013 and 2014: An Observational Study

Abstract

Diabetes mellitus (DM) is one of the leading causes of chronic kidney disease (CKD). We analyzed the prevalence of CKD in the population with diabetes in Extremadura (Spain). retrospective observational study was carried in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 38,253 patients, ≥18 years old were included. Estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration equation. CKD was defined as follow: an eGFR <60 mL/min/1.73 m2 in a time period ≥ of three months or the presence of renal damage, with or without reduced eGFR, if the urine albumin-creatinine ratio (UACR) was ≥30 mg/g, also in a time period ≥ of three months. The prevalence rate of CKD was 25.3% (27.6% in women; 23.0% in men) and increases with age (34.0% in ≥65 years-olds). 24.9% of patients with CKD were in the very-high risk category for cardiovascular events (6.3% of the diabetic population). If CKD were diagnosed without requiring sustained eGFR <60 mL/min/1.73 m2 and/or sustained UACR ≥30 mg/g (as it is frequently found in the literature) this would overestimate the prevalence of CKD by 23%.

Development and validation of a risk nomogram model for predicting pulmonary hypertension in patients with stage 3–5 chronic kidney disease

“…This is the first study to develop a nomogram to predict PAH in patients with CKD, and we found that age, DM, Hb, PLT count, Scr, LVDd, LAD, MPAD, and LVEF were independent risk factors for PAH. The prevalence of CKD increases with age, and renal function gradually decreases so that 34.0% of people ≥ 65 years old have stage 3 or above CKD [21], which may be related to elderly individuals being more prone to chronic diseases such as hypertension, diabetes, and coronary heart disease. An epidemiological study showed that the prevalence of CKD in elderly individuals over 70 years old reached 47% [22].…”

“…The prevalence of CKD increases with age, and renal function gradually decreases so that 34.0% of people ≥ 65 years old have stage 3 or above CKD [ 21 ], which may be related to elderly individuals being more prone to chronic diseases such as hypertension, diabetes, and coronary heart disease. An epidemiological study showed that the prevalence of CKD in elderly individuals over 70 years old reached 47% [ 22 ].…”

Social deprivation and diabetic kidney disease: A European view

“…Diabetic kidney disease is defined as persistent albuminuria (an albumin‐to‐creatinine ratio >3 mg/mmol), a persistently reduced renal function (an estimated glomerular filtration rate <60 mL/min per 1.73 m 2 ) or both for greater than 3 months 5 . The prevalence of DKD in people with diabetes varies depending on the cohort in the study, the population from which the sample was derived and the region studied: 42% (all types of diabetes, secondary care) in Ireland 6 , 32% (type 1 diabetes), and 42% (type 2 diabetes) in the UK (primary and secondary care) 7 , 25% (all types of diabetes, pharmacy, and clinical records) in Spain 8 , 47% (type 2 diabetes based on medication claims from insurance databases) in France 9 , and 24% (type 1 diabetes, secondary care) in Italy 10 . Risk factors for DKD include genetic determinants but also modifiable risk factors including hypertension, dyslipidemia, hyperglycemia, and smoking 10 .…”