Kidney Week

Abstract: TH-PO0358

Impact of Longer Diabetes Duration and eGFR on Cardiovascular Complications and Mortality

Session Information

• Diabetic Kidney Disease: From Early Biomarkers to Novel Therapeutic Targets
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Choi, Hong Sang, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Hong Sang Choi, MD, PhD

• Suh, Sang Heon, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Sang Heon Suh, MD, PhD

• Kim, Chang Seong, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Chang Seong Kim, MD, PhD

• Bae, Eun Hui, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Eun Hui Bae, MD, PhD

• Ma, Seong Kwon, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Seong Kwon Ma, MD, PhD

• Kim, Soo Wan, Chonnam National University Medical School, Gwangju, Korea (the Republic of)

Soo Wan Kim, MD, PhD

Background

Decreased GFR is a well-known risk factor for cardiovascular diseases and death. However, the impact of diabetes duration across the GFR on cardiovascular complications in type 2 diabetes patients have not been well studied.

Methods

Subjects with diabetes, who underwent health exams in 2015–2016 were identified in the Korean National Health Insurance Service database. Based on diabetes duration, subjects were grouped into new-onset, <5-years, 5–9-years, or ≥10-year groups. The new-onset diabetes group (eGFR: ≥90 ml/min/1.73m²) was the reference group. A Cox proportional hazards model adjusted for potential confounders was used to estimate the risk for myocardial infarction (MI), ischemic stroke (IS), and mortality.

Results

Total 2,105,228 diabetes patients were enrolled. During 3.9 years of follow-up, 36,003 (1.7%), 46,496 (2.2%), and 73,549 (3.5%) MI, IS, and death cases were identified. MI and IS risk significantly increased in all diabetes duration and eGFR groups compared with reference group, and the risk was higher with longer diabetes duration and lower eGFR. Even in new-onset diabetes group, MI and IS risk increased at eGFRs of 60-90 ml/min/1.73m² (adjusted HRs: 1.067 and 1.111; 95% CI: 1.02-1.117 and 1.066-1.158, respectively). The death risk began to increase at eGFRs of 30–60 ml/min/1.73m², and increased with declining eGFR and longer diabetes duration. eGFR ≥90 ml/min/1.73m² subgroups had higher death risk than eGFR 60-90 ml/min/1.73m² subgroups regardless of diabetic duration.

Conclusion

Increasing diabetes duration and decreasing eGFR are associated with increased risk of MI, IS, and mortality. For cardiovascular risk estimation, diabetes duration should be considered an important risk factor.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025qn0tpafd