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January 04, 2021
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‘Relatively high proportion’ of patients with diabetes experience rapid CKD progression

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Approximately 10% to 17% of patients with type 2 diabetes and newly identified chronic kidney disease had their condition worsen within 2 years, according to a study published in the Clinical Kidney Journal.

“A relatively high proportion of patients were observed with disease progression over a short period of time, highlighting the need for better identification of patients at risk [for] rapidly progressive CKD,” Csaba P. Kovesdy, MD, FASN, of the University of Tennessee Health Science Center, and colleagues wrote of the findings.

Kidneys
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For the study, researchers assessed CKD progression based on either eGFR or urine albumin to creatinine ratio (UACR). Participants were identified through U.S. administrative claims data, with the eGFR-based cohort consisting of 65,731 individuals and the UACR-based cohort consisting of 23,035 individuals.

“Patients with eGFR values had a higher prevalence of most comorbidities, greater use of cardiovascular medications and lower use of glucose-lowering agents compared to those with UACR values,” the researchers wrote.

After median follow-up of 1.3 years, the researchers observed that 50% to 64% of patients with type 2 diabetes and CKD showed no disease progression. However, Kovesdy and colleagues contended that the 10% to 17% of patients who did experience CKD stage progression over a median of 2 years made up a “nonnegligible proportion.”

“The prompt identification of these patients is crucial to informing a vulnerable population with potential unmet therapeutic need,” they wrote. “Future studies are needed to determine the clinical characteristics of these patients at risk [for] rapidly progressive CKD to inform earlier diagnostic and therapeutic interventions that slow disease progression and the need to develop better therapeutic interventions for patients at risk [for] rapid progression.”