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Late Diagnosis and Chronic Kidney Disease Progression in Patients With Type 2 Diabetes Burden Both the Patient and the Healthcare System1
Impact of CKD associated with T2D versus T2D alone
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MI CASES2,a
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HF CASES2,a
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HHF3,b
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CV DEATHS4,c
Impact of moderately to severely increased albuminuria in patients with T2D
Higher rates of
ER SERVICES5,d
Higher rates of
INPATIENT ADMISSIONS5,d
Higher rates of
RECEIVING DIALYSIS5,d
Guidelines recommend UACR to test for albuminuria in addition to eGFR at least annually in all patients with T2D1,6-8
ADA, KDIGO, and AACE Guidelines:
Recommend using both eGFR and UACR to properly identify, stage, and monitor CKD in patients with T2D, as eGFR alone may miss the earlier stages of CKD1,6-8
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aData from a cross-sectional analysis of self-reported patient data collected between 2007-2012 from 2006 adult patients with T2D in NHANES. bRandomized, double-blind, placebo-controlled SAVOR TIMI 53 trial conducted from 2010-2013 in 16,492 patients with T2D and a HbA1c of 6.5-12.0% within 6 months of randomization and either a history of ASCVD or multiple CVD risk factors. Baseline UACR was available in 15,760 patients. cThis study used data from NHANES III participants aged ≥20 years, who participated in a health examination and had available data on medications used, serum creatinine, and urine albumin and creatinine concentrations. Of these, the only participants who were included were those who had follow-up mortality data through 2006 (15,046 of 15,762 of NHANES III participants, 95.5%); 1430 (9.5%) of the 15,046 participants had T2D. dData was derived from Truven Health MarketScan databases from 2004-2014, with 23,235 patients being selected for analysis. Patients had T2D, were at least 18 years old, and were separated into normoalbuminuria (<30 mg/g UACR), microalbuminuria (30-300 mg/g UACR), and macroalbuminuria (>300 mg/g UACR) groups.
AACE, American Association of Clinical Endocrinology; ADA, American Diabetes Association; ASCVD, atherosclerotic cardiovascular disease; CKD, chronic kidney disease; CV, cardiovascular; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; ER, emergency room; HbA1c, glycated hemoglobin; HF, heart failure; HHF, hospitalization for heart failure; KDIGO, Kidney Disease Improving Global Outcomes; MI, myocardial infarction; NHANES, National Health and Nutrition Examination Survey; NHANES III; Third National Health and Nutritional Examination Survey; T2D, type 2 diabetes; UACR, urinary albumin-to-creatinine ratio.
1. Kidney Disease Improving Global Outcomes. Kidney Int Suppl. 2013;3(1):1-150. 2. Wu B, et al. BMJ Open Diabetes Res Care. 2016;4(1):e000154. 3. Scirica BM, et al. JAMA Cardiol. 2018;3(2):155-163. 4. Afkarian M, et al. J Am Soc Nephrol. 2013;24(2):302-308. 5. Zhou Z, et al. Diabetes Ther. 2017;8(3):555-571. 6. American Diabetes Association. Section 11. Diabetes Care. 2024;47(Suppl 1):S219-S230. 7. de Boer IH, et al. Diabetes Care. 2022;45(12):3075-3090. 8. Blonde L, et al. Endocr Pract. 2022;28(10):923-1049.
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