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Scope of CKD in T2D

SCOPE OF CKD IN T2D

The Impact Of CKD In T2D Is Far-reaching

29 million Americans have T2D

29 million Americans have T2D1

CKD patients are 10x more likely to die of CVD than ESKD

Patients with stage 3 CKD are 10x more likely to die from any cause (including CVD) than to progress to dialysis2,3*

ESKD is 10x more prevalent in T2D patients

Prevalence of end-stage kidney disease (ESKD) is 10 times higher in patients with diabetes compared to those without4

CKD shortens life by 16 years

CKD can shorten life expectancy of T2D patients by up to 16 years5

*A Norwegian 10-year observational study of all patients with CKD stage 3 and diabetes mellitus (N=3047).3
In pooled data of diabetes mellitus patients from 54 countries.
From a prospective cohort study of 543,412 adults in Taiwan between 1994 and 2008.

CKD: chronic kidney disease; CVD: cardiovascular disease; T2D: type 2 diabetes.

40% of patients with T2D will develop CKD

Increased risk of CV events appears early in the course of CKD and grows with time.

CKD PROGRESSION IN PATIENTS WITH T2D CAN DAMAGE THE KIDNEY AND OTHER ORGANS6

This can lead to organ failure and death. While it is rare for patients with CKD in T2D (also known as diabetic nephropathy) to die from T2D alone, even higher mortality due to CV events and ESKD is a reality.6-9

    Patients with CKD in T2D have a higher comorbidity of CV disease than patients with T2D alone10

    Patients with CKD in T2D have a higher comorbidity of CV disease

    (P<0.001)

    An evaluation of patients with CKD and T2D in Germany compared to patients without CKD (N=343,675)

    10-year mortality increases with an impaired GFR and presence of albuminuria7

    Increase incidence of mortality in type 2 diabetes patients with an impaired GFR and presence of albuminuria

    A survey examining the all-cause mortality of patients with CKD and/or T2D in the US (N=15,046).

     

    Urine albumin-to-creatinine ratio (UACR) and glomerular filtration rate (GFR) are recommended annual tests for determining kidney function and damage.11

    ESKD HAS WIDESPREAD COMPLICATIONS FOR PATIENTS

    CKD progression in T2D relentlessly follows the path toward declining kidney function, CV decline, and ultimately ESKD. Once renal function declines far enough, patients face the complications and risks associated with ESKD.8

    The standard treatments (transplant or dialysis) are far from optimal12:

    • Dialysis has a significant patient burden and a mortality rate of up to 20% per year
    • Transplantation is limited by organ shortages

    Once a patient has reached ESKD, 60% will die in the next 5 years. Even with optimal dialysis care or a transplant, results will at best achieve much less than a naturally functioning kidney, which is why protecting the kidney from CKD progression is of primary importance.2,8

    ESKD rates have remained flat, despite advancements in treatment for T2D8,13

    Chronic kidney disease progression persists in type 2 diabetes patients

    In the last few decades, advancements in glucose and blood pressure control have made important gains in reducing T2D complications. This is especially true in regards to CV events. Yet despite these gains, patients with CKD in T2D still face a substantial risk of CKD progression.8

    The incidence of ESKD in particular has improved the least, indicating that there may be a missing link in the current standard of care.13

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    References:

    • National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017.
    • Pálsson R, Patel UD. Adv Chronic Kidney Dis. 2014;21(3):273–280.
    • Eriksen BO, Ingebretsen OC. Kidney Int. 2006;69(2):375–382.
    • IDF Diabetes Atlas 2017, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017:1-147.
    • Wen CP, Chang CH, Tsai MK, et al. Kidney Int. 2017;92(2):388–396.
    • Alicic RZ, Rooney MT, Tuttle KR. Clin J Am Soc Nephrol. 2017;12(12):2032–2045.
    • Afkarian M, Sachs MC, Kestenbaum B, et al. J Am Soc Nephrol. 2013;24(2):302–308.
    • Thomas MC, Brownlee M, Susztak K, et al. Nat Rev Dis Primers. 2015;1:15018.
    • National Institute of Diabetes and Digestive and Kidney Diseases. Diabetic Kidney Disease. National Institutes of Health. Updated February 2017. Accessed September 16, 2020. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease.
    • Bramlage P, Lanzinger S, van Mark G, et al. Cardiovasc Diabetol. 2019;18(1):33.
    • Kidney Disease Improved Global Outcomes Committee. Kidney Int. 2013;3(1):1-150.
    • Breyer MD, Susztak K. Nat Rev Drug Discov. 2016;15(8):568-588.
    • Gregg EW, Li Y, Wang J, et al. N Engl J Med. 2014;370(16):1514-1523.