Prevalence and predictors of diabetic kidney disease: cross-sectional study in primary care
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease. Primary healthcare is essential for early diagnosis and management. Aim: To assess the prevalence and diagnostic accuracy of DKD. Additionally, to identify potential risk factors for DKD and evaluate the prescription of nephroprotective medications. Design and setting: Cross-sectional study on a random sample of 387 patients with type 2 diabetes in a primary care center in northern Portugal. Method: Demographic and laboratory data of patients and evidence of RASi and/or SGLT2i prescription were collected. DKD diagnosis was based on KDIGO 2012 guidelines. ICPC-2 codes U-99 and U-88 were considered adequate to identify coded DKD. Multivariable logistic regression was used to investigate associations between DKD and potential risk factors such as age, sex, BMI, hypertension, dyslipidemia, smoking, and diabetes duration, control, and its macrovascular or microvascular complications. Results: There were 338 patients included. 58% were men, with a mean (±std) age of 71.4 (±10.2) years. DKD prevalence was 42,6% [95%CI, 37.4-48.0%] with only 9.5% properly coded. Most patients were in stages G2 (33.3%), G3a (30.6%), and G3b (14.6%), and concerning albuminuria, stage A2 (68.8%). Among those with DKD, 77.1% [69.6-83.2%], 60.4% [52.3-68.0%], and 43.1% [35.3-51.2%] were medicated with RASi, SGLT2i, and both, respectively. Male sex (OR=1.89), advanced age (OR=1.08), higher BMI (OR=1.06), macrovascular DM complications (OR=1.90), and dyslipidemia (OR=4.95) were independent risk factors for DKD. Conclusions: This study highlights the high prevalence and underdiagnosis of DKD, identifying areas for practice improvement.
Authors: USF Garcia de Orta, Ana Rita Queirós, Rafael Figueiredo, ULS São João. Porto, Ana Pinho, ULS São João. Porto, Clara Fonseca, USF Garcia de Orta
Institution: Unidade Local de Saúde de Santo António EPE
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415789936
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