LEADER-6: Baseline renal function and associated factors in a high cardiovascular risk type 2 diabetes population.
To examine the prevalence of chronic kidney disease (CKD) and its associated factors in a multinational population with type 2 diabetes mellitus (T2DM) and prior cardiovascular disease (CVD).



The LEADER trial randomized 9340 participants-81.3% with prior CVD at baseline. CKD was defined as estimated GFR <60ml/min/1.73m2and/or an albumin-to-creatinine ratio ≥3.0mg/mmol.



At baseline, 51.9% of participants with prior CVD had CKD. CKD prevalence was highest in Asia (75.8%) and lowest in Europe (43.7%) and the Middle East (43.4%). Baseline factors associated with increased CKD prevalence included increased age, HbA1c, diabetes duration, systolic blood pressure or triglyceride levels; greater number of antihypertensive medications; living in Asia, the Americas or Africa versus Europe; being male; and not receiving oral antidiabetic drugs (most receiving insulin), beta-blockers or ACE inhibitors. Factors associated with decreased CKD prevalence included increased diastolic blood pressure, no diuretic treatment and prior myocardial infarction, angina or stroke.



CKD prevalence is high among patients with T2DM and prior CVD. Advanced age, long diabetes duration, poor glycemic control, comorbidities and medications used are associated with CKD. Our results strengthen the rationale for early screening and interventions for CKD in patients with T2DM and prior CVD.
Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolic Diseases, Istanbul University, Istanbul, Turkey. Electronic address: satmandiabet@gmail.com.
Ilhan
I
Satman
Diabetes Unity Department of Internal Medicine, Endocrine Division (SEMPR), Federal University of Paraná, Curitiba, Brazil.
Rosangela
R
R Rea
Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.
Mats
M
Eriksson
Diabetes Unit, Division of Internal Medicine, Hadassah Hebrew University Hospital, Ein Kerem, Jerusalem, Israel.
Ofri
O
Mosenzon
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL, United States.
Richard
R
Pratley
Novo Nordisk A/S, Bagsvaerd, Denmark.
Florian
F
M Baeres
Novo Nordisk A/S, Bagsvaerd, Denmark.
David
D
D Ørsted
Department of Nephrology, Hypertension & Rheumatology, Friedrich Alexander University of Erlangen, Munchen, Germany.
Johannes
J
F Mann
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors
Cardiovascular disease; Chronic kidney disease; Demographics; Geographical region; Race; Type 2 diabetes mellitus