Abstract: FR-PO0561
Systolic Blood Pressure, Not Glycemic Control, Predicts CKD in Pakistani Primary Care Patients with Type 2 Diabetes (T2DM): A Multicenter Retrospective Study
Session Information
- CKM: Clinical - Meta-Analyses, Predictive Modeling, Care Delivery, and Safety
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Sajjad, Mobeen, Sajjad Medical Clinic, Gujranwala, Punjab, Pakistan
- Baig Mirza, Sammeullah, Saad Hospital & Cardiac Care Center, Daska, Punjab, Pakistan
Background
Diabetic nephropathy is a principal driver of CKD globally, yet critically underdiagnosed in primary care in developing nations. In Pakistan, inadequate dialysis infrastructure, high renal replacement costs, and low health literacy amplify this burden. We determined CKD prevalence and independent predictors among T2DM patients in Pakistani primary care.
Methods
We conducted a multicenter retrospective study across 5 sites in Punjab, Pakistan (Oct 2025–Apr 2026). 100 T2DM patients were enrolled. Variables included HbA1c, serum creatinine, SBP, diabetes duration, and urine albumin. eGFR was calculated using CKD-EPI 2021. Pearson correlation and multivariate logistic regression were used. Cohort: 46%M, 54%F. Conducted per Declaration of Helsinki principles.
Results
Mean age: 54.4 years (range 22–80). Mean HbA1c was 9.3%; 65% exhibited suboptimal glycemic control (HbA1c ≥8.0%). Mean SBP was 144.8 mmHg; 77% were hypertensive. Mean DM duration: 11.6 years. CKD (eGFR <60 mL/min/1.73m2) was present in 36%: G3a 9%, G3b 14%, G4 8%, G5 5%. 13% with G4–G5 CKD lacked dialysis access due to cost — Rs.5,000/session (~$18 USD) amid public facility shortages. HbA1c failed to predict eGFR decline (r=−0.131, p>0.05). In contrast, SBP (r=−0.586), diabetes duration (r=−0.423), and age (r=−0.530) each correlated significantly with eGFR decline (all p<0.001). On multivariate logistic regression, SBP was the sole independent predictor of CKD (OR 3.73, 95% CI 1.75–7.92, p<0.001); age and duration lost significance after adjustment (Nagelkerke R2=0.39). Albuminuria (all 100): A1 22%, A2 47%, A3 31%. Albuminuria was excluded from regression as it constitutes a CKD-defining criterion; it showed the strongest univariate correlation with eGFR decline (r=−0.699, p<0.001): CKD prevalence escalated by grade: 0% (A1), 19.1% (A2), 87.1% (A3).
Conclusion
SBP is the sole independent predictor of CKD on multivariate analysis, while glycemic control showed no significant association. Reduced kidney function affects 36% of T2DM patients in Pakistani primary care; 13% in advanced stages lack dialysis access. eGFR and albuminuria grading confirm progressive nephropathy severity. Limitations include retrospective design, small sample, and regional scope. Integrated hypertension control, systematic renal screening, and subsidized dialysis are urgently needed in resource-limited settings.
Acknowledgment
The authors sincerely acknowledge the administrative and clinical staff of the five participating primary care sites across Punjab, Pakistan, whose cooperation made this research possible. Diagnostic services were generously provided by Aga Khan Laboratory, Chughtai Lab, and three affiliated centers. This study was conducted in full accordance with the Declaration of Helsinki. No external funding, grants, or sponsorships were received. The authors declare no conflicts of interest.