CKD BURDEN

THE IMPACT OF CHRONIC KIDNEY DISEASE ON PATIENTS WITH TYPE 2 DIABETES IS EXTENSIVE

As of 2019, approximately 463 million adults ages 20–79 have diabetes worldwide, of which around 90% have T2D⁵

Up to 40% of patients with type 2 diabetes develop chronic kidney disease⁶

Patients with stage 3 CKD are 10x more likely to die from any cause (including CV disease) than to progress to stage 5 CKD, dialysis, or kidney transplantation¹*

CKD can shorten life expectancy of patients with diabetes by up to 16 years, relative to the general population with neither disease⁴

Risk of CV events appears early in the course of CKD in patients with T2D and grows with disease severity.⁷

COMPARED WITH T2D ALONE, COMORBID KIDNEY DISEASE INCREASES CV MORTALITY

CKD and T2D increase 10-year CV mortality chart

CKD PROGRESSION CAN HAVE SERIOUS CONSEQUENCES FOR PATIENTS

CKD progression in T2D follows a path toward declining kidney function, increased risk of cardiovascular complications (including ischemia, arrhythmia, and heart failure) and ultimately end-stage renal disease. Once renal function declines below a certain threshold, patients face the complications and risks associated with ESKD.^8,9

Once patients reach ESKD, approximately 60% will die in the next 5 years.¹ The cost-utility ratio of dialysis in Canada amounts to $103,779 (per quality-adjusted life-year).¹⁰ The patient experience is disruptive to normal work and life and associated with a negative impact to quality of life.¹¹ Protecting the kidney from CKD progression is of primary importance.

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* A Norwegian 10-year observational study of patients with CKD stage 3 (N=3047).

CKD: chronic kidney disease; CV: cardiovascular; ESKD: endstage kidney disease; T2D: type 2 diabetes.

References

1.	Levin A, Stevens PE, Bilous RW, et al. (2013). Kidney disease: Improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements, 3(1), 1-150. https://doi.org/10.1038/kisup.2012.732. Wen, C.. Diabetes with early kidney involvement may shorten life expectancy by 16 years. Kidney International, 2017;92(2), 388–396. https://doi.org/10.1016/j.kint.2017.01.030
4.	Wen, C. Diabetes with early kidney involvement may shorten life expectancy by 16 years. Kidney International, 2017;92(2), 388–396. https://doi.org/10.1016/j.kint.2017.01.030
5.	International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels; 2019. Accessed January 29, 2021. Available at: https://www.diabetesatlas.org
6.	Yee J. Diabetic Kidney Disease: Chronic Kidney Disease and Diabetes. Diabetes Spectrum 2008 Jan; 21(1): 8-10. doi.org/10.2337/diaspect.21.1.8
7.	Amod A, et al.; DEVOTE Study Group. Diabetes Ther. 2020;11(1):53–70.
8.	Levin A, Stevens PE, Bilous RW, et al. (2013). Kidney disease: Improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements, 3(1), 1-150. https://doi.org/10.1038/kisup.2012.73
9.	Imig JD, Ryan MJ. Immune and inflammatory role in renal disease. Compr Physiol. 2013 Apr;3(2):957-76. doi: 10.1002/cphy.c120028. PMID: 23720336; PMCID: PMC3803162.
10.	Ferguson, T. W., Whitlock, R. H., Bamforth, R. J., et al. 2021; 3(1). Kid. Med. doi:10.1016/j.xkme.2020.07.011
11.	Tong A, Sainsbury P, Chadban S, et al. Patients’ experiences and perspectives of living with CKD. Am J Kidney Dis. 2009 Apr;53(4):689-700. doi: 10.1053/j.ajkd.2008.10.050. Epub 2009 Feb 11. PMID: 19216015.