Diabetes Metab J.  2018 Jun;42(3):224-232. 10.4093/dmj.2017.0065.

Higher Prevalence and Progression Rate of Chronic Kidney Disease in Elderly Patients with Type 2 Diabetes Mellitus

• Kim KS
• Park SW
• Cho YW
• Kim SK

• KMID: 2413985
• DOI: http://doi.org/10.4093/dmj.2017.0065

Abstract

BACKGROUND
To evaluate the prevalence of chronic kidney disease (CKD) and progression rate to CKD in elderly patients with type 2 diabetes mellitus (T2DM).
METHODS
We investigated the medical records of 190 elderly patients (65 years or older) with T2DM from 2005 to 2011 in 6-month increments. Mean follow-up duration was 64.5 months. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or the presence of albuminuria.
RESULTS
The mean age was 70.4 years and mean diabetes duration was 10.6 years. Among all the participants, 113 patients (59.5%) had CKD. The eGFR was significantly decreased between baseline (65.7±15.0 mL/min/1.73 m²) and the end of follow-up (52.7±17.5 mL/min/1.73 m², P < 0.001). At the end of follow-up, the prevalence of eGFR < 60 mL/min/1.73 m² had increased by 61.6% (at baseline, 44.2%). Furthermore, in patients with eGFR ≥60 mL/min/1.73 m², the progression rate to more than CKD stage 3 was 39.6% at the end of follow-up; 30.2% of elderly diabetic patients had progressed to albuminuria from normoalbuminuria. Kaplan-Meier analysis showed that the time interval to worsening nephropathy was significantly shorter in elderly patients with diabetes duration ≥10 years than in those with diabetes duration < 5 years (P=0.018).
CONCLUSION
CKD was commonly observed in older patients with T2DM, and the progression rate to CKD is also high. Consequently, it is important to identify and manage CKD as early as possible in elderly patients with T2DM, especially in those with diabetes duration ≥10 years.

Keyword

Aged; Albuminuria; Diabetes mellitus, type 2; Morbidity; Renal insufficiency, chronic

MeSH Terms

Aged*
Albuminuria
Diabetes Mellitus, Type 2*
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kaplan-Meier Estimate
Medical Records
Prevalence*
Renal Insufficiency, Chronic*

Figure

• 

  Fig. 1 Comparison of estimated glomerular filtration rate (eGFR) from baseline to the end of follow-up. aP<0.05.

• 

  Fig. 2 Kaplan-Meier plots for renal survival according to the duration of diabetes mellitus.

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