title: Five-year incidence of chronic kidney disease (stage 3-5) and associated risk factors in a Spanish cohort: the MADIABETES Study.
abstract: OBJECTIVE
  To evaluate the incidence rate of Chronic Kidney Disease (CKD) stage 3-5 (persistent decreased kidney function under 60 mL/min per 1.73 m2) among patients with type 2 diabetes over five years, to identify the risk factors associated with CKD, and develop a risk table to predict five-year CKD stage 3-5 risk stratification for clinical use.
  
  
  METHODS
  The MADIABETES Study is a prospective cohort study of 3,443 outpatients with type 2 diabetes mellitus, sampled from 56 primary health care centers (131 general practitioners) in Madrid (Spain).
  
  
  RESULTS
  The cumulative incidence of CKD stage 3-5 at five-years was 10.23% (95% CI = 9.12-11.44) and the incidence density was 2.07 (95% CI = 1.83-2.33) cases per 1,000 patient-months or 2.48 (95% CI = 2.19-2.79) cases per 100 patient-years. The highest hazard ratio (HR) for developing CKD stage 3-5 was albuminuria ≥ 300 mg/g (HR = 4.57; 95% CI= 2.46-8.48). Furthermore, other variables with a high HR were age over 74 years (HR = 3.20; 95% CI = 2.13-4.81), a history of Hypertension (HR = 2.02; 95% CI = 1.42-2.89), Myocardial Infarction (HR= 1.72; 95% IC= 1.25-2.37), Dyslipidemia (HR = 1.68; 95% CI 1.30-2.17), duration of diabetes mellitus ≥ 10 years (HR = 1.46; 95% CI = 1.14-1.88) and Systolic Blood Pressure >149 mmHg (HR = 1.52; 95% CI = 1.02-2.24).
  
  
  CONCLUSIONS
  After a five-year follow-up, the cumulative incidence of CKD is concordant with rates described in Spain and other countries. Albuminuria ≥ 300 mg/g and age over 74 years were the risk factors more strongly associated with developing CKD (Stage 3-5). Blood Pressure, lipid and albuminuria control could reduce CKD incidence of CKD in patients with T2DM.
authors: Gerencia de Atención Primaria. Gerencia Adjunta de Planificación y Calidad, Servicio Madrileño de Salud. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
authors: Miguel A
authors: MA
authors: Salinero-Fort
authors: Centro de Salud Las Calesas, Servicio Madrileño de Salud, Madrid, Spain.
authors: Francisco J
authors: FJ
authors: San Andrés-Rebollo
authors: Servicio de Medicina Preventiva, Hospital Universitario La Paz, Servicio Madrileño de Salud. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
authors: Carmen
authors: C
authors: de Burgos-Lunar
authors: Plataforma de Apoyo al Investigador Novel, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
authors: Paloma
authors: P
authors: Gómez-Campelo
authors: Unidad de Medicina Interna, Hospital Central de la Defensa Gómez Ulla, Servicio Madrileño de Salud, Madrid, Spain.
authors: Rosa M
authors: RM
authors: Chico-Moraleja
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Madrid, Spain.
authors: Ana
authors: A
authors: López de Andrés
authors: Preventive Medicine and Public Health Department, Rey Juan Carlos University, Madrid, Spain.
authors: Rodrigo
authors: R
authors: Jiménez-García
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D018709:Statistics, Nonparametric; D013997:Time Factors