Prevalence of Chronic Kidney Disease in Unselected Swedish Patients with Type 2 Diabetes and its Association with Cardiovascular Disease

Abstract Aim: To estimate the prevalence of Chronic Kidney Disease (CKD) and albuminuria and its associations to prevalent cardiovascular co-morbidities in patients with type 2 diabetes in a primary care setting in Sweden. Patients and Methods: Cross-sectional data on demography, laboratory measurements, current medication, previous cardiovascular disease and major events of hypoglycaemia during the last 12 months was consecutively recorded from 53 primary care centers. Stage of CKD was defined based on the presence of albuminuria and estimated Glomerular Filtration Rate (eGFR) according to KDIGO. Albuminuria was measured using the urinary albumin-creatinine ratio. Results: We included 362 men and 226 women aged 68.5±9.3 years with a mean diabetes duration 9.9±7.2 years. 220 patients (37%) were categorized as having CKD stage 1-5, 105 subjects (18%) CKD 1-2, and 115 subjects (20%) CKD 3-5. In the CKD 1-5 categories, micro albuminuria was prevalent in 128 (58.2%) subjects and macro albuminuria in 27 (12.3%) subjects. The Odds Ratio (OR), adjusted for age and gender, for subjects with CKD 3-5 for having retinopathy was 2.71 (95% CI 1.14 to 6.25, p=0.02) and for myocardial infarction 1.91 (95% CI 1.04 to 3.45, p=0.03) compared with CKD 0-2. Levels of hemoglobin were lower (133 ±14 g/L vs. 143 ±12 g/L) in CKD 3-5 compared to CKD 0-2 (p<0.01). Furthermore, the prevalence of vascular disease (p=0.03) and ischemic stroke (p=0.02) were higher in subjects with albuminuria compared with individuals without. Conclusion: Chronic kidney disease is common in type 2 diabetes in a primary care setting and associated with prevalent vascular co-morbidities