Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 9, 2023
Date Accepted: May 16, 2024
Prevalence and Risk Factors of Chronic Kidney Disease in Patients with Type 2 Diabetes in China: A Cross-Sectional Study
ABSTRACT
Background:
Chronic kidney disease (CKD) is a serious, long-term complication of diabetes and a leading cause of end-stage kidney disease.
Objective:
This study aimed to provide representative nationwide data addressing the prevalence of CKD in patients with type 2 diabetes and associated risk factors in China.
Methods:
An analysis of baseline data from an ongoing prospective observational IMPROVE study. The participants were administered questionnaires, and each person underwent laboratory assessment with blood and urine samples. Descriptive statistics were used for data analysis. Logistic regression analyses were performed to identify the risk factors associated with CKD in patients with type 2 diabetes.
Results:
We conducted a national study between December 2021 and September 2022. 9,672 participants with type 2 diabetes from 45 hospitals were included in the study. The prevalence, screening and awareness rates of CKD in patients with type 2 diabetes were 30.99% [95% CI 29.33, 32.64], 54.75% [95% CI 54.3, 56.09], and 27.03% [95% CI 23.97, 30.09], respectively. A higher prevalence of CKD was observed in subgroups characterized by older age, long course of type 2 diabetes, and residing in fourth-tier cities. The awareness and screening rates were higher in teaching and economically developed areas. Of those with an eGFR ≥ 90 mL/min/1.73 m2, 24.16% had proteinuria. Among individuals with a UACR < 30 mg/g, 3.39% had an eGFR < 60 mL/min/1.73 m2. Patients with type 2 diabetes who were unaware of CKD had higher rates of HbA1c ≥ 7%, TC > 5.18 μmol/L, LDL-C > 3.37 μmol/L, BMI ≥ 30 kg/m2, and hypertension compared to those who were aware of CKD. This study identified screening, awareness, smoking, age, diabetes duration, concomitant antihypertensive medications, concomitant microcirculation medications, diabetic foot, diabetic retinopathy, diabetic neuropathy, hypertension, elevated low-density lipoprotein cholesterol levels, and poor glycemic control as risk factors for CKD. Insulin, metformin, and sodium-glucose co-transporter-2 inhibitors were the three most commonly used hypoglycemic medications.
Conclusions:
Among adult patients with type 2 diabetes in China, the prevalence of CKD was 30.99%, coupled with low screening and awareness rates.
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