Patient and disease characteristics of type-2 diabetes patients with or without chronic kidney disease: an analysis of the German DPV and DIVE databases.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2002-
    • Subject Terms:
      Albuminuria/*epidemiology ; Diabetes Mellitus, Type 2/*epidemiology ; Diabetic Nephropathies/*epidemiology ; Renal Insufficiency, Chronic/*epidemiology; Age Factors ; Aged ; Albuminuria/diagnosis ; Albuminuria/drug therapy ; Albuminuria/physiopathology ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Austria/epidemiology ; Comorbidity ; Databases, Factual ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/drug therapy ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/drug therapy ; Diabetic Nephropathies/physiopathology ; Diuretics/therapeutic use ; Female ; Germany/epidemiology ; Glomerular Filtration Rate ; Humans ; Hypoglycemic Agents/therapeutic use ; Kidney/physiopathology ; Luxembourg/epidemiology ; Male ; Middle Aged ; Prevalence ; Registries ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/drug therapy ; Renal Insufficiency, Chronic/physiopathology ; Risk Assessment ; Risk Factors ; Sex Factors
    • Abstract:
      Background: To evaluate the characteristics of type 2 diabetes (T2DM) patients with or without chronic kidney disease (CKD) in Germany.
      Methods: Using combined DPV/DIVE registry data, the analysis included patients with T2DM at least ≥ 18 years old who had an estimated glomerular filtration rate (eGFR) value available. CKD was defined as an eGFR < 60 mL/min/1.73 m 2 or eGFR ≥ 60 mL/min/1.73 m 2 and albuminuria (≥ 30 mg/g). Median values of the most recent treatment year per patient are reported.
      Results: Among 343,675 patients with T2DM 171,930 had CKD. Patients with CKD had a median eGFR of 48.9 mL/min/1.73 m 2 and 51.2% had a urinary albumin level ≥ 30 mg/g. They were older, had a longer diabetes duration and a higher proportion was females compared to patients without CKD (all p < 0.001). More than half of CKD patients (53.5%) were receiving long-acting insulin-based therapy versus around 39.1% of those without (p < 0.001). CKD patients also had a higher rate of hypertension (79.4% vs 72.0%; p < 0.001). The most common antihypertensive drugs among CKD patients were renin-angiotensin-aldosteron system inhibitors (angiotensin converting enzyme inhibitors 33.8%, angiotensin receptor blockers 14.2%) and diuretics (40.2%). CKD patients had a higher rate of dyslipidemia (88.4% vs 86.3%) with higher triglyceride levels (157.9 vs 151.0 mg/dL) and lower HDL-C levels (men: 40.0 vs 42.0 mg/dL; women: 46.4 vs 50.0 mg/dL) (all p < 0.001) and a higher rate of hyperkalemia (> 5.5 mmol/L: 3.7% vs. 1.0%). Comorbidities were more common among CKD patients (p < 0.001).
      Conclusion: The results illustrate the prevalence and morbidity burden associated with diabetic kidney disease in patients with T2DM in Germany. The data call for more attention to the presence of chronic kidney disease in patients with diabetes, should trigger intensified risk factor control up and beyond the control of blood glucose and HbA1c in these patients. They may also serve as a trigger for future investigations into this patient population asking for new treatment options to be developed.
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    • Contributed Indexing:
      Keywords: Chronic kidney disease; DIVE; DPV; Disease characteristics; Patient characteristics; Type-2-diabetes
    • Accession Number:
      0 (Angiotensin Receptor Antagonists)
      0 (Angiotensin-Converting Enzyme Inhibitors)
      0 (Diuretics)
      0 (Hypoglycemic Agents)
    • Publication Date:
      Date Created: 20190318 Date Completed: 20190423 Latest Revision: 20231006
    • Publication Date:
      20240105
    • Accession Number:
      PMC6420726
    • Accession Number:
      10.1186/s12933-019-0837-x
    • Accession Number:
      30878037