Prevalence, screening and treatment of chronic kidney disease in people with type 2 diabetes in France: The ENTRED surveys (2001 and 2007)

Assogba, Géoffroy Frank Azimafoussé; Couchoud, Cécile; Roudier, Candice; Pornet, Carole; Fosse, S.; Romon, I.; Druet, C.; Stengel, Bénédicte; Fagot-Campagna, A.

doi:10.1016/j.diabet.2012.08.004

Cited by 55 publications

(41 citation statements)

References 21 publications

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“…Our results were close to that previously observed [40]. Studies conducted to define incidence for CKD are scarce, most of studies evaluate its prevalence [3–5, 40]. Prevalence studies indicate CKD burden whereas incidence studies contribute to the implementation of longitudinal follow-up and the monitoring of CKD progression, and may therefore suggest prevention strategies.…”

Section: Discussionsupporting

confidence: 89%

“…Second, because of the non interventional design of our study, only patients who were prescribed creatinine measurement could be identified. Another limitation was the scarcity of proteinuria determination, although presence of proteinuria was recognized to predispose to ESRD, even with a normal renal function [3, 5, 13, 55, 57, 59, 60]. Our results were consistent with previous findings highlighting that special attention must be paid to improve albuminuria screening [3, 5].…”

Section: Discussionsupporting

confidence: 87%

“…Thus screening strategies to increase early recognition of individuals at risk were developed implementing surveillance of elevated plasma creatinine, microalbuminuria, and more recently routine reporting of estimated glomerular filtration rate (eGFR) in a high-risk target population [3, 15–22]. Family general practitioners (GPs) are responsible for CKD screening and timely referral to nephrologist.…”

Section: Introductionmentioning

confidence: 99%

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Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the EPIRAN community-based study

et al. 2016

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BackgroundAlthough chronic kidney disease (CKD) affects a growing number of people, epidemiologic data on incident CKD in the general population are scarce. Screening strategies to increase early CKD detection have been developed.MethodsFrom a community-based sample of 4,409 individuals residing in a well-defined geographical area, we determined the number of patients having a first serum creatinine value ≥1.7 mg/dL and present for at least 3 months that allowed us to calculate an annual incidence rate of CKD (stages 3 to 5). CKD (stages 3 to 5) was defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. We also described the primary care, outcomes and risk factors associated with outcomes using competing risks analyses for these CKD patients.ResultsA total of 631 incident CKD patients (stages 3 to 5) were followed-up until the occurrence of death and dialysis initiation for more than 3 years. The annual incidence rate of CKD (stages 3 to 5) was estimated at 977.7 per million inhabitants. Analyses were performed on 514 patients with available medical data. During the study, 155 patients (30.2 %) were referred to a nephrologist, 193 (37.5 %) died and 58 (11.3 %) reached end-stage renal disease and initiated dialysis. A total of 139 patients (27.6 %) had a fast decline of their renal function, 92 (18.3 %) a moderate decline and the 272 remaining patients had a physiological decline (21.1 %) or a small improvement of their renal function (33.0 %). Predictors of death found in both Cox and Fine-Gray multivariable regression models included age at diagnosis, anemia, active neoplasia and chronic heart failure, but not a low glomerular filtration rate (GFR). Age at diagnosis, anemia and a low GFR were independently associated with dialysis initiation in Cox model, but anemia was not found to be a risk factor for dialysis initiation in Fine-Gray model.ConclusionsThis large cohort study provided useful epidemiological data on incident CKD (stages 3 to 5) and stressed the need to improve the hands-on implementation of clinical practice guidelines for the evaluation and the management of CKD in primary care.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the EPIRAN community-based study

et al. 2016

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“…It also confirms the results of another published research on glucose lowering strategies used by GPs for these patients [15], showing that metformin and sulfonylurea were the most prescribed glucose lowering agents. The authors of the latter study explained that the presence of kidney disease which, in some cases, remained unidentified did not significantly influence the prescribing of glucose lowering agents.…”

Section: Discussionsupporting

confidence: 88%

“…For example, data from the 2007 ENTRED cohort [15] showed that two-thirds of T2DM patients had low GFR values: 14% with CKD stage 3a and 8% with CKD stages 3b, 4, or 5. Among this latter group, the proportion of people aged over 75 years and of women is significantly higher than that in the populations of T2DM patients with lower stages of CKD.…”

Section: Introductionmentioning

confidence: 99%

Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study

Grandfils

Detournay

Attali³

et al. 2013

International Journal of Endocrinology

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Aim. To understand glucose lowering therapeutic strategies of French general practitioners (GPs) in the management of type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD). Methods. A multicenter cross-sectional study was conducted from March to June 2011 among a sample of French GPs who contribute to the IMS Lifelink Disease Analyzer database. Eligible patients were those with T2DM and moderate-to-severe CKD who visited their GPs at least once during the study period. Data were collected through electronic medical records and an additional questionnaire. Results. 116 GPs included 297 patients: 86 with stage 3a (Group 1, GFR = 45–60 mL/min/1.73 m2) and 211 with stages 3b, 4, or 5 (Group 2, GFR < 45 mL/min/1.73 m2). Patients' mean age was approximately 75 years. Insulin was used in 19% of patients, and was predominant in those with severe CKD. More than two-thirds of patients were treated with glucose lowering agents which were either contraindicated or not recommended for CKD. Conclusion Physicians most commonly considered the severity of diabetes and not CKD in their therapeutic decision making, exposing patients to potential iatrogenic risks. The recent patient oriented approach and individualization of glycemic objectives according to patient profile rather than standard HbA1c would improve this situation.

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Cardio‐renal‐metabolic disease in primary care setting

Ibrahim,

Ba‐Essa,

Baker

et al. 2023

Diabetes Metabolism Res

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In the primary care setting providers have more tools available than ever before to impact positively obesity, diabetes, and their complications, such as renal and cardiac diseases. It is important to recognise what is available for treatment taking into account diabetes heterogeneity. For those who develop type 2 diabetes (T2DM), effective treatments are available that for the first time have shown a benefit in reducing mortality and macrovascular complications, in addition to the well‐established benefits of glucose control in reducing microvascular complications. Some of the newer medications for treating hyperglycaemia have also a positive impact in reducing heart failure (HF). Technological advances have also contributed to improving the quality of care in patients with diabetes. The use of technology, such as continuous glucose monitoring systems (CGM), has improved significantly glucose and glycated haemoglobin A1c (HbA1c) values, while limiting the frequency of hypoglycaemia. Other technological support derives from the use of predictive algorithms that need to be refined to help predict those subjects who are at great risk of developing the disease and/or its complications, or who may require care by other specialists. In this review we also provide recommendations for the optimal use of the new medications; sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i) and Glucagon‐like peptide‐receptor agonists 1 (GLP1RA) in the primary care setting considering the relevance of these drugs for the management of T2DM also in its early stage.

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Prevalence, screening and treatment of chronic kidney disease in people with type 2 diabetes in France: The ENTRED surveys (2001 and 2007)

Cited by 55 publications

References 21 publications

Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the EPIRAN community-based study

Competing risk of death and end-stage renal disease in incident chronic kidney disease (stages 3 to 5): the EPIRAN community-based study

Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study

Cardio‐renal‐metabolic disease in primary care setting

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