Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Population-Based Study

Aims: Chronic kidney disease (CKD) is a common complication of Type 2 diabetes that frequently co-occurs with cardiovascular disease. We aimed to characterise CKD in adults with Type 2 diabetes, quantify its prevalence across severity levels and examine pharmacological treatment patterns and healthcare utilisation. Material and Methods: We conducted a population-based cross-sectional analysis using electronic medical records from a national health organisation in Israel. CKD status was defined using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR). Extracted variables included demographic and clinical characteristics, comorbidities, medication use, community consultations and hospital encounters. Results: The cohort included 62 661 adults with Type 2 diabetes, of whom 30.7% met criteria for CKD: mild, moderate and severe CKD risk levels accounted for 19.7%, 6.4% and 4.6%, respectively. Higher CKD level was associated with greater cardiovascular morbidity, with heart failure showing the strongest relationship (adjusted prevalence ratio 2.4; 95% CI 2.3–2.6 for the most advanced stage vs. no CKD). Other diabetes complications, including retinopathy and neuropathy, also increased with CKD severity (adjusted prevalence ratios 2.0; 95% CI 1.9–2.1 and 1.4; 95% CI 1.3–1.5, respectively). Metformin, lipid-lowering agents and ACE inhibitors/ARBs were the most frequently used medications. With CKD progression, rates of nephrology, endocrinology and cardiology consultations rose, as did emergency department visits and hospitalisations. Conclusions: CKD is common amongst Israeli adults with Type 2 diabetes and is strongly linked to cardiovascular and other diabetes-related complications. More advanced CKD stages correspond to substantially higher healthcare utilisation, reflecting escalating healthcare burden with CKD progression.