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Abstract: PO0436

Defining the Excess Risk of Adverse Kidney Outcomes in CKD Patients with Type 2 Diabetes in the DISCOVER-CKD Cohort

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Abdul Sultan, Alyshah, AstraZeneca, Cambridge, United Kingdom
  • Nolan, Stephen, AstraZeneca, Cambridge, United Kingdom
  • Carrero, Juan Jesus, Karolinska Institute, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Jiang, Zhuoxin, AstraZeneca, Gaithersburg, Maryland, United States
  • Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • James, Glen, AstraZeneca, Cambridge, United Kingdom
  • Garcia Sanchez, Juan Jose, AstraZeneca, Cambridge, United Kingdom
  • Carolyn, Lam Su ping, National Heart Centre Singapore, Singapore, Singapore
  • Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States
  • Kanda, Eiichiro, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
  • Pollock, Carol A., Royal North Shore Hospital, St Leonards, New South Wales, Australia
  • Wheeler, David C., University College London, London, London, United Kingdom
  • L Heerspink, Hiddo Jan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Chronic Kidney Disease (CKD) patients with type 2 diabetes (T2D) are considered at a high risk of cardiovascular events. However, the excess risk of major kidney events in T2D patients compared to patients without T2D is unknown.


DISCOVER-CKD is an international observational study of patients with CKD that encompasses large retrospective electronic medical records (EMR) and claims data between 2008 and 2020. Preliminarily, data from US-based Limited Claims and Electronic Health Record (LCED) data (IBM Health, Armonk, NY) and TriNetx (hospital-based EMR) were analysed. CKD patients (eGFR <75 mL/min/1.73m2) aged ≥18 years with ≥1 record of urine albumin to creatinine ratio (UACR) were identified. T2D status was ascertained any time before the index date (2nd eGFR measurement). The risk of kidney outcomes (sustained ≥50% eGFR decline or end-stage kidney disease) was compared between patients with and without T2D at 5 years’ follow-up.


Compared to non-T2D patients, T2D patients had a slightly higher incidence rate of adverse renal outcomes (LCED: 2.7% versus 2.3% per year; TriNetX: 1.8% versus 1.2% per year). After adjusting for all confounding factors (Figure 1) we observed no increased risk of adverse renal outcomes in patients with T2D compared to non-T2D patients in LCED (hazard ratio (HR): 1.08: 95%CI 0.81-1.43) and a 34% increased risk in TriNetX database (HR:1.34; 95%CI 1.11-1.62).


There is an excess risk of adverse renal outcomes in CKD patient with T2D compared to those without T2D.This is explained to a large extent by conventional risk markers in LCED but not completely in TriNetX. Both groups (T2D and non-T2D) should be managed proactively to reduce the risk of poor clinical outcomes.


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