Presentation (CTI)

OBJECTIVES: Chronic kidney disease (CKD) is a common complication among individuals with diabetes, affecting approximately 30% of patients. CKD can lead to additional comorbidity such as end-stage renal disease and cardiovascular disease. We aimed to describe the prevalence of CKD across the different disease stages in Israeli adults with type 2 diabetes, and to assess their clinical characteristics and healthcare utilization patterns.
METHODS: A cross-sectional study based on medical records from one of Israel's health maintenance organizations and including all members aged 18 and above diagnosed with type 2 diabetes. CKD prevalence was determined based on estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR). We extracted demographic and clinical data, information about pharmacological use, presence of comorbidities, and primary care and specialist visits in the past year.
RESULTS: The study population comprised 67,500 diabetes patients, out of whom 37% had possible CKD. The mean diabetes duration was 7.1 years, with a longer duration (7.9 years) among CKD patients. BMI levels were similar between those with and without CKD. Poor glycemic control (HbA1c >7%) was observed in 41% of CKD patients, compared to 32% of non-CKD patients. Cardiovascular disease was more prevalent among CKD patients (56%), increasing with CKD stage progression, while 36% of non-CKD diabetics had CVD. Specialist consultations were sought by 53% of CKD patients, including 11% nephrology, 25% cardiology, and 34% endocrinology, compared to 43% among non-CKD diabetics, which were mostly endocrinology consults.
CONCLUSIONS: CKD is highly prevalent among adults with type-2 diabetes in Israel and is associated with an increased burden of cardiovascular comorbidity and healthcare utilization. The expected global rise in diabetes calls for improved prevention and care strategies for this subgroup of patients.