SCOPE OF CKD IN T2D
The Impact Of CKD In T2D Is Far-reaching
*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
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
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
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
- 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.