Abstract
Objective
To examine the prevalence of chronic kidney disease (CKD) and related cardiovascular
morbidity in a cross-sectional population in patients with type 2 diabetes (T2D) treated
in a primary care setting in Finland.
Research design and methods
Data were collected and recorded from 42 primary care centres, which recruited 629
patients diagnosed with type 2 diabetes (T2D) to this non-interventional study. Data
including patient characteristics, kidney function and albuminuria, blood pressure,
HbA1c, lipid and lipoprotein levels, and diabetes duration as well as current medication
was collected in each patient.
Results
In the final study population of 625 patients, the mean age was 67 years (range 29–92
years), BMI 32.8 kg/m2 (95% CI 32–33), blood pressure 142/80 mmHg (140–143/80–81) and HbA1c 7.1% (7.0–7.2) (53.8 mmol/mol, 53–55) and the median duration of diabetes was 9.2 years ranging from newly
diagnosed to 43 years. History of dyslipidemia had in 73.3% of patients, 27.8% had
cardiovascular disease and 82.7% had hypertension. The primary endpoint, prevalence
of CKD of any grade (1–5) or albuminuria, was 68.6%. Regarding declined renal function,
16.2% of patients had an estimated glomerular filtration rate (eGFR) <60 ml/min/1.72 m2, classifying as CKD 3–5. Only one patient was within CKD5. Regarding renal damage,
albuminuria was present in 24.3% of patients, with microalbuminuria in 17.1% and macroalbuminuria
in 7.2%, respectively. Combining the patients with CKD 3–5 and/or the presence of
albuminuria, 34.7% seemed to suffer from significant CKD. The proportion of patients
with albuminuria increased with a decrease in glomerular filtration rate. Historically,
diabetic nephropathy had been diagnosed in 24.3% of the patients.
Conclusions
Nearly 70% of patients with T2D treated in primary care in Finland have some sign
of CKD and nearly half of all T2D patients have a significant CKD. However, only half
of the latter had it diagnosed and documented in their patient charts, thus highlighting
the importance of performing routine screening of nephropathy by measuring both albuminuria
and eGFR in patients with T2D. Prevention of this complication with active therapy
for risk factors, such as hypertension and dyslipidemia is warranted.
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Article info
Publication history
Published online: July 21, 2014
Accepted:
June 1,
2014
Received in revised form:
May 11,
2014
Received:
December 23,
2013
Identification
Copyright
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.
