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Prevalence and progression of chronic kidney disease among patients with type 2 diabetes: Insights from the DISCOVER study
Author(s) -
Khunti Kamlesh,
Charbonnel Bernard,
Chen Hungta,
Cherney David Z.,
Cooper Andrew,
Fenici Peter,
Gomes Marilia B.,
Hammar Niklas,
Heerspink Hiddo J. L.,
Ji Lig,
Medina Jesús,
Nicolucci Antonio,
Ramirez Larisa,
Rathmann Wolfgang,
Shestakova Marina V.,
Shimomura Iichiro,
Tang Fengming,
Watada Hirotaka,
Kosiborod Mikhail
Publication year - 2021
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14401
Subject(s) - interquartile range , kidney disease , renal function , medicine , creatinine , type 2 diabetes , diabetes mellitus , observational study , urology , stage (stratigraphy) , gastroenterology , endocrinology , biology , paleontology
Abstract We report the prevalence and change in severity of chronic kidney disease (CKD) in DISCOVER, a global, 3‐year, prospective, observational study of patients with type 2 diabetes (T2D) initiating second‐line glucose‐lowering therapy. CKD stages were defined according to estimated glomerular filtration rate (eGFR). Overall, 7843 patients from 35 countries had a baseline serum creatinine measurement. Of these (56.7% male; mean age: 58.1 years; mean eGFR: 87.5 mL/min/1.73 m 2 ), baseline prevalence estimates for stage 0‐1, 2, 3 and 4‐5 CKD were 51.4%, 37.7%, 9.4% and 1.4%, respectively. A total of 5819 patients (74.2%) also had at least one follow‐up serum creatinine measurement (median time between measurements: 2.9 years, interquartile range: 1.9‐3.0 years). Mean eGFR decreased slightly to 85.7 mL/min/1.73 m 2 over follow‐up. CKD progression (increase of ≥1 stage) occurred in 15.7% of patients, and regression (decrease of ≥1 stage) in 12.0%. In summary, a substantial proportion of patients with T2D developed CKD or had CKD progression after the initiation of second‐line therapy. Renal function should be regularly monitored in these patients, to ensure early CKD diagnosis and treatment.