Kidney Week

Abstract: SA-PO172

Socioeconomic, Demographic, and Clinical Associations of CKD in Diabetes in a Population-Based Australian Cohort: Results from the EXTEND45 Study

Session Information

• Diabetic Kidney Disease: Clinical - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Sukkar, Louisa, The George Institute for Global Health, Sydney, New South Wales, Australia

Louisa Sukkar,

• Kang, Amy, The George Institute for Global Health, Sydney, New South Wales, Australia

Amy Kang,

• Jun, Min, The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia

Min Jun,

• Foote, Celine, The George Institute for Global Health, Sydney, New South Wales, Australia

Celine Foote,

• Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, Paraná, Brazil

Roberto Pecoits-Filho,

• Neuen, Brendon Lange, The George Institute for Global Health, Sydney, New South Wales, Australia

Brendon Lange Neuen,

• Rogers, Kris, The George Institute for Global Health, Sydney, New South Wales, Australia

Kris Rogers,

• Cass, Alan, Menzies School of Health Research, Darwin, Northern Territory, Australia

Alan Cass,

• Pollock, Carol A., The University of Sydney, St. Leonards, New South Wales, Australia

Carol A. Pollock,

• Wong, Germaine, The University of Sydney, St. Leonards, New South Wales, Australia

Germaine Wong,

• Knight, John, The George Institute for Global Health, Sydney, New South Wales, Australia

John Knight,

• Peiris, David, The George Institute for Global Health, Sydney, New South Wales, Australia

David Peiris,

• Gallagher, Martin P., The George Institute for Global Health, Sydney, New South Wales, Australia

Martin P. Gallagher,

• Jardine, Meg J., The George Institute for Global Health, UNSW, Newtown, New South Wales, Australia

Meg J. Jardine,

Group or Team Name

• EXTEND45 Steering Committee

Background

Type 2 diabetes is the leading cause of Chronic Kidney Disease (CKD) in the developed world. Identifying people with diabetes at increased risk of developing CKD is the first step to developing preventative strategies to reduce this burden. We aimed to estimate the incidence rate and associations of CKD in people with diabetes.

Methods

Based on data from the EXTEND45 study (the 45 and Up Study linked to [1] hospital and community pathology datasets by the Centre for Health Record Linkage [CHeReL] and [2] the Medicare Benefits Schedule [MBS] and Pharmaceutical Benefits Scheme [PBS] datasets provided by the Department of Human Services), we identified a population-based Australian cohort (2006-2014) of 24,400 people aged ≥45 years with diabetes. We used Poisson regression to estimate CKD (eGFR<60 ml/min/1.73m²) incidence and prevalence. Multivariable Cox regression was used to examine associations between baseline sociodemographic factors, comorbidities and incident CKD

Results

Of 24,400 participants with diabetes, 2,789 (11.4%) had prevalent CKD and 1,771 (7.2%) developed incident CKD over a mean follow-up of 4.3 years. CKD incidence rate was 4.93 (95% confidence interval [CI]: 4.70-5.16) per 100 person-years. Compared to those who had no CKD, those with CKD were older (mean age: 64.7, 75.2, 70.2 years, for no CKD, prevalent CKD, incident CKD respectively), had a lower proportion of current smokers (7.9%, 3.1% 4.7% respectively) and a lower proportion with an annual household income of >$70,000 (17.1%, 6.2%, 10.5%). Incident CKD was predicted by age (hazard ratio [HR]: 1.07 [1.07-1.08] per year increase), geography (Outer regional vs major city: 1.41 [1.17-1.69]), BMI (obese vs normal: 1.43 [1.23-1.68]), presence of hypertension (1.48 [1.27-1.73]), coronary heart disease (1.24 [1.11-1.40]) and depression (1.26 [1.09-1.45]).

Conclusion

In a contemporary cohort of Australians with diabetes, the incidence of CKD is high and independently predicted by age as well as geography, obesity, a baseline history of cardiovascular disease and depression. These associations provide potential targets for early intervention in these at risk groups.

Funding

• Commercial Support – The EXTEND45 Study is funded through peer-reviewed (NSW Cardiovascular Research Network Collaborative Project Grant), and unrestricted industry (from MSD, Amgen and Eli Lilly) research grants.