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High prevalence of chronic kidney disease in Finnish patients with type 2 diabetes treated in primary care.
Prim Care Diabetes. 2015 Feb; 9(1):31-8.PC

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/m(2) (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 m(2), 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.

Authors+Show Affiliations

Turku University Hospital, Department of Nephrology, Finland.Boehringer Ingelheim, Sweden.University of Turku, Finland.Faculty of Health Sciences, School of Medicine, University of Eastern Finland, Finland.Obesity Research Unit, Biomedicum, Departments of Medicine and Psychiatry, Helsinki University Central Hospital, Finland.Boehringer Ingelheim, Finland.Eli Lilly, Finland.Stat-Consulting, Nokia, Finland.Eli Lilly, Finland. Electronic address: Koivisto_Veikko@network.lilly.com.Mehiläinen Diabetes Clinic, Helsinki, Finland.No affiliation info available

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25066820

Citation

Metsärinne, Kaj, et al. "High Prevalence of Chronic Kidney Disease in Finnish Patients With Type 2 Diabetes Treated in Primary Care." Primary Care Diabetes, vol. 9, no. 1, 2015, pp. 31-8.
Metsärinne K, Bröijersen A, Kantola I, et al. High prevalence of chronic kidney disease in Finnish patients with type 2 diabetes treated in primary care. Prim Care Diabetes. 2015;9(1):31-8.
Metsärinne, K., Bröijersen, A., Kantola, I., Niskanen, L., Rissanen, A., Appelroth, T., Pöntynen, N., Poussa, T., Koivisto, V., & Virkamäki, A. (2015). High prevalence of chronic kidney disease in Finnish patients with type 2 diabetes treated in primary care. Primary Care Diabetes, 9(1), 31-8. https://doi.org/10.1016/j.pcd.2014.06.001
Metsärinne K, et al. High Prevalence of Chronic Kidney Disease in Finnish Patients With Type 2 Diabetes Treated in Primary Care. Prim Care Diabetes. 2015;9(1):31-8. PubMed PMID: 25066820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High prevalence of chronic kidney disease in Finnish patients with type 2 diabetes treated in primary care. AU - Metsärinne,Kaj, AU - Bröijersen,Anders, AU - Kantola,Ilkka, AU - Niskanen,Leo, AU - Rissanen,Aila, AU - Appelroth,Tina, AU - Pöntynen,Nora, AU - Poussa,Tuija, AU - Koivisto,Veikko, AU - Virkamäki,Antti, AU - ,, Y1 - 2014/07/21/ PY - 2013/12/23/received PY - 2014/05/11/revised PY - 2014/06/01/accepted PY - 2014/7/29/entrez PY - 2014/7/30/pubmed PY - 2015/9/10/medline SP - 31 EP - 8 JF - Primary care diabetes JO - Prim Care Diabetes VL - 9 IS - 1 N2 - 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/m(2) (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 m(2), 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. SN - 1878-0210 UR - https://www.unboundmedicine.com/medline/citation/25066820/High_prevalence_of_chronic_kidney_disease_in_Finnish_patients_with_type_2_diabetes_treated_in_primary_care_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1751-9918(14)00072-2 DB - PRIME DP - Unbound Medicine ER -