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Diabetes Duration Is Associated with Declining Kidney Function: eGFR and CKD Burden Across Duration.

Carmen Pantis1,2, Cosmin Mihai Vesa2,3, Timea Claudia Ghitea4

  • 1Clinical County Emergency Hospital Bihor, 410169 Oradea, Romania.

Journal of Clinical Medicine
|March 28, 2026
PubMed
Summary

Diabetes duration significantly impacts kidney function, with longer disease duration independently increasing chronic kidney disease risk. Early nephroprotective strategies are crucial for type 2 diabetes management.

Keywords:
CKDchronic kidney diseasediabetes durationdiabetic kidney diseaseeGFRhypertensionmetabolic exposuremicrovascular complicationsrenal declinetype 2 diabetes mellitus

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Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetology

Background:

  • Diabetic kidney disease (DKD) is a major complication of type 2 diabetes mellitus (T2DM), leading to chronic kidney disease (CKD) globally.
  • The independent contribution of diabetes duration to renal decline, beyond aging and hypertension, requires further definition.

Purpose of the Study:

  • To investigate the independent association between diabetes duration and kidney function decline in adults with T2DM.
  • To quantify the risk of developing CKD associated with prolonged diabetes duration.

Main Methods:

  • Cross-sectional study of 250 adults with T2DM, analyzing diabetes duration continuously and in strata.
  • Primary endpoint: estimated glomerular filtration rate (eGFR). Functional CKD defined as eGFR < 60 mL/min/1.73 m².
  • Linear and logistic regression models adjusted for age, sex, BMI, hypertension, and HbA1c.

Main Results:

  • Mean eGFR declined significantly with increasing diabetes duration (p < 0.001).
  • CKD prevalence was 54.2% in patients with ≥15 years of diabetes vs. ~15-18% in shorter-duration groups (p < 0.001).
  • Each diabetes year independently associated with 1.32 mL/min/1.73 m² eGFR decline and increased CKD odds by 10.7% (adjusted OR=1.11).

Conclusions:

  • Diabetes duration is a strong, independent predictor of declining kidney function in T2DM.
  • Prolonged exposure to hyperglycemia significantly elevates CKD risk, independent of other risk factors.
  • Highlights the progressive nephrotoxic effects of diabetes, emphasizing the need for early and sustained nephroprotection.