Prevalence and progression of chronic kidney disease among patients with type 2 diabetes: Insights from the DISCOVER study

• Published in: Diabetes, obesity & metabolism Vol. 23; no. 8; pp. 1956 - 1960
• Main Authors: Khunti, Kamlesh, Charbonnel, Bernard, Chen, Hungta, Cherney, David Z., Cooper, Andrew, Fenici, Peter, Gomes, Marilia B., Hammar, Niklas, Heerspink, Hiddo J. L., Ji, Linong, Medina, Jesús, Nicolucci, Antonio, Ramirez, Larisa, Rathmann, Wolfgang, Shestakova, Marina V., Shimomura, Iichiro, Tang, Fengming, Watada, Hirotaka, Kosiborod, Mikhail
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2021; Wiley Subscription Services, Inc
• Subjects: Cohort analysis; cohort study; Creatinine; Diabetes; diabetes complications; Diabetes mellitus (non-insulin dependent); Diabetic nephropathy; Epidermal growth factor receptors; Glomerular filtration rate; Glucose; Kidney diseases; Medicin och hälsovetenskap; Patients; Renal function; type 2 diabetes; cohort study; type 2 diabetes; diabetes complications; diabetic nephropathy
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.14401

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 m2), 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 m2 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.