Journal
DIABETES OBESITY & METABOLISM
Volume 23, Issue 8, Pages 1956-1960Publisher
WILEY
DOI: 10.1111/dom.14401
Keywords
cohort study; diabetes complications; diabetic nephropathy; type 2 diabetes
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Funding
- AstraZeneca
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The study found that a significant proportion of patients with type 2 diabetes developed chronic kidney disease (CKD) or experienced progression of CKD after initiating second-line therapy. Regular monitoring of renal function is recommended to ensure early diagnosis and treatment of CKD.
We report the prevalence and change in severity of chronic kidney disease (CKD) in DISCOVER, a global, 3-year, prospective, observational study of patients with type 2 diabetes (T2D) initiating second-line glucose-lowering therapy. CKD stages were defined according to estimated glomerular filtration rate (eGFR). Overall, 7843 patients from 35 countries had a baseline serum creatinine measurement. Of these (56.7% male; mean age: 58.1 years; mean eGFR: 87.5 mL/min/1.73 m(2)), baseline prevalence estimates for stage 0-1, 2, 3 and 4-5 CKD were 51.4%, 37.7%, 9.4% and 1.4%, respectively. A total of 5819 patients (74.2%) also had at least one follow-up serum creatinine measurement (median time between measurements: 2.9 years, interquartile range: 1.9-3.0 years). Mean eGFR decreased slightly to 85.7 mL/min/1.73 m(2) over follow-up. CKD progression (increase of >= 1 stage) occurred in 15.7% of patients, and regression (decrease of >= 1 stage) in 12.0%. In summary, a substantial proportion of patients with T2D developed CKD or had CKD progression after the initiation of second-line therapy. Renal function should be regularly monitored in these patients, to ensure early CKD diagnosis and treatment.
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