Undiagnosed chronic kidney disease in people with type 2 diabetes in Spain: Prevalence, treatment patterns and associated factors in a multicentre cross-sectional study
Abstract
BACKGROUND AND AIM: Chronic kidney disease (CKD) remains underdiagnosed in people with type 2 diabetes mellitus (T2DM), particularly in early stages, despite its strong association with renal disease progression, cardiovascular outcomes, and current guideline recommendations for early cardio-renal protective interventions. Contemporary, nationally representative primary care data from Spain evaluating CKD underdiagnosis in people with T2DM are limited. This study estimated the prevalence of diagnosed and undiagnosed CKD in adults with T2DM in Spain, described treatment patterns by CKD diagnosis status, and identified factors associated with undiagnosed CKD.
METHODS: A planned secondary analysis of the DIAMOND2 multicentre cross-sectional study was performed in Spanish primary care. Data were retrospectively collected from electronic medical records during the calendar year 2022, and the analysis was performed between January and July 2023. Data from 5009 adults with T2DM randomly selected from 70 centres were analysed. CKD was defined according to KDIGO 2024 criteria as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or urine albumin-to-creatinine ratio (uACR) ≥ 30 mg/g. Patients were classified as having diagnosed CKD (recorded), undiagnosed CKD (meeting criteria without record), or no CKD. Descriptive statistics were used, and multivariable Poisson regression models with robust variance were fitted to identify factors associated with undiagnosed CKD.…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 5,009 participants or records.
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