Work

Type 2 diabetes, cardiovascular disease and chronic kidney disease in Hungary: multimorbidity and 11-year survival in a nationwide retrospective study

Year: 2026

Type: article

Abstract: OBJECTIVES: To examine the prevalence in Hungary of selected cardiovascular-kidney-metabolic (CKM) conditions (type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and chronic kidney disease (CKD)) and their combinations and to assess 11-year overall survival (OS) by baseline disease status. DESIGN: Nationwide, retrospective, population-based cohort study. SETTING: Hungarian National Health Insurance Fund database; follow-up up to 132 months from 1 January 2013. PARTICIPANTS: Patients aged ≥20 years with International Classification of Diseases, 10th Revision codes for T2DM, CVD or CKD recorded between 1 January 2011 and 31 December 2012 and alive on 1 January 2013. INTERVENTIONS: Not applicable (observational study); the exposure was baseline disease status. PRIMARY AND SECONDARY OUTCOME MEASURES: Point prevalence of T2DM, CVD, CKD and their combinations by age and sex on 1 January 2013, OS by baseline disease status (Cox proportional hazards models, with disease status fixed at baseline throughout follow-up) and longitudinal changes in health status within each baseline cohort. RESULTS: On 1 January 2013, 1 059 087 patients (13.4% of the population aged ≥20 years) had a T2DM, CVD or CKD diagnosis recorded in the previous 2 years; 211 549 (20%) were multimorbid. At 132 months, patients with stand-alone T2DM, CVD or CKD had age- and sex-standardised OS rates of 54.2%, 53.8% and 44.3%, respectively. Coexistence of all three conditions was associated with an 11-year OS of 21.0% (median OS: 62 months). Male sex, older age and additional comorbidities were associated with significantly higher risks of death. CONCLUSIONS: A substantial proportion of patients with T2DM, CVD or CKD, alone or in combination, developed additional comorbidities or died during follow-up, including in younger age groups. The frequent coexistence of these conditions and the steep survival gradient across them support the rationale for the CKM syndrome framework. TRIAL REGISTRATION NUMBER: Not applicable.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-117598