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

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.