title: High prevalence of chronic kidney disease in Finnish patients with type 2 diabetes treated in primary care.
abstract: OBJECTIVE
  To examine the prevalence of chronic kidney disease (CKD) and related cardiovascular morbidity in a cross-sectional population in patients with type 2 diabetes (T2D) treated in a primary care setting in Finland.
  
  
  METHODS
  Data were collected and recorded from 42 primary care centres, which recruited 629 patients diagnosed with type 2 diabetes (T2D) to this non-interventional study. Data including patient characteristics, kidney function and albuminuria, blood pressure, HbA1c, lipid and lipoprotein levels, and diabetes duration as well as current medication was collected in each patient.
  
  
  RESULTS
  In the final study population of 625 patients, the mean age was 67 years (range 29-92 years), BMI 32.8 kg/m(2) (95% CI 32-33), blood pressure 142/80 mmHg (140-143/80-81) and HbA1c 7.1% (7.0-7.2) (53.8 mmol/mol, 53-55) and the median duration of diabetes was 9.2 years ranging from newly diagnosed to 43 years. History of dyslipidemia had in 73.3% of patients, 27.8% had cardiovascular disease and 82.7% had hypertension. The primary endpoint, prevalence of CKD of any grade (1-5) or albuminuria, was 68.6%. Regarding declined renal function, 16.2% of patients had an estimated glomerular filtration rate (eGFR) <60 ml/min/1.72 m(2), classifying as CKD 3-5. Only one patient was within CKD5. Regarding renal damage, albuminuria was present in 24.3% of patients, with microalbuminuria in 17.1% and macroalbuminuria in 7.2%, respectively. Combining the patients with CKD 3-5 and/or the presence of albuminuria, 34.7% seemed to suffer from significant CKD. The proportion of patients with albuminuria increased with a decrease in glomerular filtration rate. Historically, diabetic nephropathy had been diagnosed in 24.3% of the patients.
  
  
  CONCLUSIONS
  Nearly 70% of patients with T2D treated in primary care in Finland have some sign of CKD and nearly half of all T2D patients have a significant CKD. However, only half of the latter had it diagnosed and documented in their patient charts, thus highlighting the importance of performing routine screening of nephropathy by measuring both albuminuria and eGFR in patients with T2D. Prevention of this complication with active therapy for risk factors, such as hypertension and dyslipidemia is warranted.
authors: Turku University Hospital, Department of Nephrology, Finland.
authors: Kaj
authors: K
authors: Metsärinne
authors: Boehringer Ingelheim, Sweden.
authors: Anders
authors: A
authors: Bröijersen
authors: University of Turku, Finland.
authors: Ilkka
authors: I
authors: Kantola
authors: Faculty of Health Sciences, School of Medicine, University of Eastern Finland, Finland.
authors: Leo
authors: L
authors: Niskanen
authors: Obesity Research Unit, Biomedicum, Departments of Medicine and Psychiatry, Helsinki University Central Hospital, Finland.
authors: Aila
authors: A
authors: Rissanen
authors: Boehringer Ingelheim, Finland.
authors: Tina
authors: T
authors: Appelroth
authors: Eli Lilly, Finland.
authors: Nora
authors: N
authors: Pöntynen
authors: Stat-Consulting, Nokia, Finland.
authors: Tuija
authors: T
authors: Poussa
authors: Eli Lilly, Finland. Electronic address: Koivisto_Veikko@network.lilly.com.
authors: Veikko
authors: V
authors: Koivisto
authors: Mehiläinen Diabetes Clinic, Helsinki, Finland.
authors: Antti
authors: A
authors: Virkamäki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011320:Primary Health Care; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents