Characteristics, cardiovascular comorbidity and medicines management in patients with type 2 diabetes and CKD: results of the IRIDIEM study.
BACKGROUND
Type 2 diabetes is a leading cause of chronic kidney disease (CKD). The purpose of the Individual Risk-Profiling and Treatment in Diabetes Management (IRIDIEM) study was to evaluate the characteristics of CKD and associated comorbidities in patients with type 2 diabetes and CKD.


METHODS
IRIDIEM was conducted as a cross-sectional survey in 109 centres in 11 countries and included 1,205 patients aged >or=50 years with type 2 diabetes for >or=5 years and CKD stage 2-4.


RESULTS
50% of patients were in CKD stage 4; 42% had CKD stage 3, and 4% were in CKD stage 2. Concomitant risk factors for cardiovascular disease and/or progression of CKD included hypertension (92% of patients), proteinuria (74%), hypercholesterolaemia (65%), and hypertriglyceridaemia (44%). Only 64% of patients with hypertension had received antihypertensive medication. Anaemia was present in 34% of patients and increased markedly with advanced CKD stages. Of patients with documented anaemia, only 19% had received epoetin and only 7% had received iron treatment.


CONCLUSIONS
IRIDIEM documents the need to improve adherence to current best practice guidelines for management of cardiorenal risk factors including earlier initiation of antihypertensive treatment, lipid and anaemia management in this high-risk patient population.
Stevens
P E
PE
Department of Renal Medicine, Kent and Canterbury Hospital, Canterbury, UK. paul.stevens@ekht.nhs.uk
Schernthaner
G
G
Raptis
S
S
Wanner
C
C
Scherhag
A
A
Lameire
N
N
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors