Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns-NHANES 2007-2012.
OBJECTIVE
To describe the estimated prevalence and temporal trends of chronic kidney disease (CKD) treatment patterns, and the association between CKD and potential factors for type 2 diabetes mellitus (T2DM) in different demographic subgroups.


METHODS
This was a cross-sectional analysis of adults with T2DM based on multiple US National Health and Nutrition Examination Survey (NHANES) datasets developed during 2007-2012. CKD severity was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines using the CKD Epidemiology Collaboration (CKD-EPI) equation: mild to moderate=stages 1-3a; moderate to kidney failure=stages 3b-5. Multivariable logistic regression analyses were performed to assess the associations between CKD and potential factors.


RESULTS
Of the adult individuals with T2DM (n=2006), age-adjusted CKD prevalence was 38.3% during 2007-2012; 77.5% were mild-to-moderate CKD. The overall age-adjusted prevalence of CKD was 40.2% in 2007-2008, 36.9% in 2009-2010, and 37.6% in 2011-2012. The prevalence of CKD in T2DM was 58.7% in patients aged ≥65 years, 25.7% in patients aged <65 years, 43.5% in African-Americans and Mexican-Americans, and 38.7% in non-Hispanic whites. The use of antidiabetes and antihypertensive medications generally followed treatment guideline recommendations. Older age, higher hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and having hypertension were significantly associated with CKD presence but not increasing severity of CKD.


CONCLUSIONS
CKD continued to be prevalent in the T2DM population; prevalence remained fairly consistent over time, suggesting that current efforts to prevent CKD could be improved overall, especially by monitoring certain populations more closely.
HealthCore Inc. , Wilmington, Delaware , USA.
Bingcao
B
Wu
AstraZeneca R&D , Fort Washington, Pennsylvania , USA.
Kelly
K
Bell
Bristol-Myers Squibb Company , Plainsboro, New Jersey , USA.
Amy
A
Stanford
HealthCore Inc. , Wilmington, Delaware , USA.
David M
DM
Kern
HealthCore Inc. , Wilmington, Delaware , USA.
Ozgur
O
Tunceli
HealthCore Inc. , Wilmington, Delaware , USA.
Suma
S
Vupputuri
AstraZeneca R&D , Fort Washington, Pennsylvania , USA.
Iftekhar
I
Kalsekar
HealthCore Inc. , Wilmington, Delaware , USA.
Vincent
V
Willey
Health Care Management; Kidney Disorder; Kidney Failure; Kidney Function Test