Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Population-Based Study

Chronic kidney disease (CKD) is a common complication of Type 2 diabetes that frequently co-occurs with cardiovascular disease. We aimed to characterise CKD in adults with Type 2 diabetes, quantify its prevalence across severity levels and examine pharmacological treatment patterns and healthcare utilisation.

We conducted a population-based cross-sectional analysis using electronic medical records from a national health organisation in Israel. CKD status was defined using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR). Extracted variables included demographic and clinical characteristics, comorbidities, medication use, community consultations and hospital encounters.

The cohort included 62 661 adults with Type 2 diabetes, of whom 30.7% met criteria for CKD: mild, moderate and severe CKD risk levels accounted for 19.7%, 6.4% and 4.6%, respectively. Higher CKD level was associated with greater cardiovascular morbidity, with heart failure showing the strongest relationship (adjusted prevalence ratio 2.4; 95% CI 2.3-2.6 for the most advanced stage vs. no CKD). Other diabetes complications, including retinopathy and neuropathy, also increased with CKD severity (adjusted prevalence ratios 2.0; 95% CI 1.9-2.1 and 1.4; 95% CI 1.3-1.5, respectively). Metformin, lipid-lowering agents and ACE inhibitors/ARBs were the most frequently used medications. With CKD progression, rates of nephrology, endocrinology and cardiology consultations rose, as did emergency department visits and hospitalisations.

CKD is common amongst Israeli adults with Type 2 diabetes and is strongly linked to cardiovascular and other diabetes-related complications. More advanced CKD stages correspond to substantially higher healthcare utilisation, reflecting escalating healthcare burden with CKD progression.