Impact of ethnicity on faster progression of kidney function loss in an ethnically diverse cohort of people with T2DM
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Individuals with type 2 diabetes often experience varied progression rates to advanced chronic kidney disease (CKD). Aim: This study aimed to investigate the trajectories of estimated glomerular filtration rate (eGFR) in an ethnically diverse cohort of urban type 2 diabetes patients and to assess the impact of ethnicity on CKD progression and associated risk factors. Method: The study included 14,572 patients with type 2 diabetes from two teaching hospitals, followed from 2004 to 2018. The cohort was ethnically diverse: 45 % White, 37.8 % Black, 9.1 % Asian, 2.7 % mixed, and 5.2 % other. Participants had a baseline eGFR >45 ml/min/1.73 m2. Group-Based Trajectory Models (GBTM) were used to identify eGFR progression patterns in the five main ethnic groups, based on entropy, Bayesian Information Criteria (BIC), Akaike Information Criteria (AIC), and participant composition. Multinomial logistic regression analyzed clinical/biochemical features associated with faster CKD progression, with White as the reference group. Results: Among the 14,572 participants, 17.4 % (2,531; 62.5 % male) exhibited the fastest eGFR decline. This group comprised 19.4 % White (mean age 66.4 years, 33.9 % female), 15.1 % Black (mean age 63.1 years, 43.8 % female), 18.0 % Asian (mean age 64.3 years, 35.2 % female), 19.9 % mixed (mean age 62.2 years, 39.7 % female), and 15.0 % other ethnicity (mean age 64.2 years, 35.75 % female). Baseline eGFR ranged from 55.85 to 58.52 ml/min/1.73 m2 across ethnicities. During follow-up, 368 (14.5 %) progressed to stage 5 CKD. After adjusting for age, blood pressure, albuminuria, HbA1c, gender, and baseline eGFR, the risk of reaching stage 5 CKD was significantly higher in non-White groups compared to Whites: Black (RRR 1.64), Asian (RRR 2.39), mixed (RRR 1.97), and other (RRR 3.72). Conclusion: The study highlights the need for tailored healthcare strategies and early intervention to address the specific risk profiles of different ethnic groups. Prompt management of modifiable risk factors is crucial to slowing CKD progression and reducing associated morbidity and mortality.
Authors: T. Alobaid, S. Ayis, J. Karalliedde, M. O’Connell
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,410
OpenAlex ID: W4417316041
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