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Time to develop chronic kidney disease in an Ecuadorian Type 2 Diabetes Mellitus cohort: Survival analysis in primary care

Abstract:

Chronic Kidney Disease (CKD) represents a high burden to health systems. However, the survival time for CKD in a Type 2 Diabetes Mellitus (T2DM) population is unknown. Aims: Determine the risk factors, survival time and the incidence rate of CKD in T2DM. Methods: Retrospective clinical cohort study (follow up 10 years). 513 patients with T2DM were included. Numerical variables were compared using the mean difference. Chi squared and odds ratios were calculated for categorical variables. Survival analysis was done through life tables and Kaplan-Meier. Results: The mean difference between the group that developed CKD and those who did not, was significant in: age, age at diagnosis of T2DM and years with T2DM. Risk factors for developing CKD were: the presence of hypertension, albuminuria, retinopathy, high triglycerides and high HbA1c. The incidence rate was 32.07 per 1000 person-years of follow-up and 207 (40.4%) of patients developed CKD during the study. The median for developing CKD was 20.52 years of disease with an increasing risk with time. Conclusions: Half of the patients with T2DM will develop CKD by the second decade of disease. Time, arterial hypertension, retinopathy, albuminuria and triglycerides are factors associated with CKD in patients with T2DM.