Secular trends of epidemiologic patterns of chronic kidney disease over three decades: an updated analysis of the Global Burden of Disease Study 2019

BMJ Open, Journal Year: 2023, Volume and Issue: 13(3), P. e064540 - e064540

Published: March 1, 2023

Objectives To assess the characteristics of global death burden imposed by chronic kidney disease (CKD) and attributable risk factors from 1990 to 2019 help inform a framework for policy discussions, resource allocation research priorities. Design A population-based observational study. Setting The data relative were obtained Global Burden Disease (GBD) Study database. Main outcome measures Based on GBD database, we estimated CKD stratified sociodemographic index (SDI), geographic location, sex, age group, time period 2019. Results Over three decade study period, number CKD-related deaths increased 0.60 million (95% uncertainty interval (UI): 0.57–0.63 million) in 1.43 UI: 1.31–1.52 age-standardised rate (ASDR) CKD, among all causes, 15th 10th Globally, ASDR males was higher than that females. mainly occurred those aged over 50 years, especially regions with SDIs. negatively related SDI (ρ=−0.603, p<0.0001). Among factors, metabolic systolic blood pressure, fasting plasma glucose body mass index, main contributors deaths. Although high-temperature-related low, trend sharply lower regions. Conclusions continue increase, majority occurring elderly adults. is Additionally, increasing burdens should receive social attention.

Language: Английский

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Cardiorenal diseases in type 2 diabetes mellitus: clinical trials and real-world practice

Nature Reviews Endocrinology, Journal Year: 2022, Volume and Issue: 19(3), P. 151 - 163

Published: Nov. 29, 2022

Language: Английский

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Mortality, Outcomes, Costs, and Use of Medicines Following a First Heart Failure Hospitalization

JACC Heart Failure, Journal Year: 2023, Volume and Issue: 11(10), P. 1320 - 1332

Published: June 21, 2023

There are few contemporary data on outcomes, costs, and treatment following a hospitalization for heart failure (hHF) in epidemiologically representative cohorts.This study sought to describe rehospitalizations, use of guideline-directed medical therapy (GDMT) (renin-angiotensin system inhibitors, sacubitril/valsartan, beta-blockers, mineralocorticoid receptor antagonists, sodium-glucose cotransporter-2 inhibitors), mortality after hHF.EVOLUTION HF (Utilization Dapagliflozin Other Guideline Directed Medical Therapies Heart Failure Patients: A Multinational Observational Study Based Secondary Data) is an observational, longitudinal cohort using from electronic health records or claims sources Japan, Sweden, the United Kingdom, States. Adults with first hHF discharge between 2018 2022 were included. The 1-year event rates per 100 patient-years (ERs) death rehospitalizations (with primary diagnosis (HF), chronic kidney disease [CKD], myocardial infarction, stroke, peripheral artery disease) calculated. Hospital care costs cumulatively summarized. Cumulative GDMT was assessed Kaplan-Meier estimates.Of 263,525 patients, 28% died within year post-hHF (ER: 28.4 [95% CI: 27.0-29.9]). Rehospitalizations mainly driven by 13.6 9.8-17.4]) CKD 4.5 3.6-5.3]), whereas ERs lower. Health predominantly CKD. Between 2020 2022, renin-angiotensin antagonists changed little, uptake inhibitors increased 2- 7-fold.Incident rehospitalization risks high, little discharge, highlighting need consider earlier greater implementation manage reduce costs.

Language: Английский

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Mortality, Health Care Burden, and Treatment of CKD: A Multinational, Observational Study (OPTIMISE-CKD)

Kidney360, Journal Year: 2024, Volume and Issue: 5(3), P. 352 - 362

Published: Feb. 1, 2024

Key Points Newly detected, moderately progressed CKD is associated with high clinical risks and health care costs. Most patients do not have diabetes are at the same risk as those diabetes. Substantial inertia kidney-protective treatment observed when detected. Background Kidney-protective treatments (renin–angiotensin system inhibitors sodium–glucose cotransporter-2 [SGLT-2is]) can delay progression, cardiovascular events, death. Methods This observational cohort study used electronic records claims data from Japan, Sweden, United States to assess 1-year mortality/hospitalization event rates per 100 patient-years (PYs), cumulative hospital costs patient, use before/after SGLT-2i (dapagliflozin) approval for (2021) stage 3–4 with/without type 2 (T2D). Results Among 449,232 (across-country median age range 74–81 years), 79% did T2D. Prevalence ranges atherosclerotic disease heart failure were 20%–36% 17%–31%, respectively. Baseline inhibitor and/or SGLT-2i) was limited, especially among without Event (11.4–44.4/100 PYs) (7.4–22.3/100 PYs). Up 14.6% of had died within 1 year. Hospital higher than disease. After incident CKD, initiation low (8%–20%) discontinuation (16%–27%), Conclusions Incident substantial morbidity, mortality, costs, undertreatment, in T2D, who represented majority patients. highlights an urgent need early detection better moderate CKD.

Language: Английский

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Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries

Diabetes Obesity and Metabolism, Journal Year: 2022, Volume and Issue: 24(7), P. 1277 - 1287

Published: March 24, 2022

To examine how the development of cardiovascular and renal disease (CVRD) translates to hospital healthcare costs in individuals with type 2 diabetes (T2D) initially free from CVRD.

Language: Английский

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Cardiovascular and renal diseases in type 2 diabetes patients: 5-year cumulative incidence of the first occurred manifestation and hospitalization cost: a cohort within the French SNDS nationwide claims database

Cardiovascular Diabetology, Journal Year: 2024, Volume and Issue: 23(1)

Published: Jan. 9, 2024

Abstract Background Myocardial infarction (MI), stroke, peripheral arterial disease (PAD), heart failure (HF) and chronic kidney (CKD) are common cardiovascular renal diseases (CVRD) manifestations for type 2 diabetes. The objective was to estimate the incidence of first occurring CVRD manifestation cumulative hospitalization costs each diabetes without history. Methods A cohort study all free as January 1st 2014, identified followed-up 5 years within French SNDS nationwide claims database. estimated using function, with death a competing risk. Cumulative were from perspective payers. Results From 2,079,089 cancer or transplantation, 76.5% at baseline mean age 65 years, 52% women 7% microvascular complications 15.3% after follow-up constant linear increase over time manifestations: most frequent CKD representing 40.6% occurred manifestation, followed by HF (23.0%), then PAD (13.5%), stroke (13.2%) MI (9.7%). together reached about one patient out ten represented 63.6% manifestations. 5-year global cost hospitalizations 3.9 billion euros (B€), i.e. 2,450€ per whole cohort, an exponential specific manifestation. costliest (2.0 B€), (1.2 (0.7 (0.6 B€) (0.3 B€). Conclusions/interpretation While MI, remain classic major risks CVRD-free diabetes, nowadays represent individually higher risk than these manifestations, jointly represents twice high three together. This should encourage development preventive strategies.

Language: Английский

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Missed opportunities to manage complex comorbidity of heart failure, type 2 diabetes mellitus and chronic kidney disease: a retrospective cohort study

Heart, Journal Year: 2025, Volume and Issue: unknown, P. heartjnl - 325046

Published: March 4, 2025

Effective management of coexisting heart failure (HF), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2D) is critical, yet evidence adherence to guideline-recommended standards in routine care remains unclear. We aimed assess primary for patients with overlapping HF, CKD T2D England. Using UK Clinical Practice Research Datalink (1998-2020), we evaluated across 161 529 individuals or before after developing a second these conditions. analysed investigation rates, medication use predictors guideline adherence. identified followed by HF (CKD+HF, 40%), CKD+T2D (51.3%) HF+T2D (8.6%) median 3.1 years follow-up the diagnosis. In CKD+HF, groups, prescription rates renin-angiotensin system inhibitors (71%, 64.1% 74.4%), beta-blockers (53.1%,36.2% 55.1%), antiplatelets (56.2%, 45.2% 54.4%) statins (56.7%, 68.5% 72%) were suboptimal. Advanced age, female sex, peripheral arterial cancer associated lower likelihood checking blood pressure, creatinine glycated haemoglobin (HbA1C) diagnoses, respectively. The first diagnosis was reduced odds having HbA1C measured (OR 0.79, 95% CI 0.72 0.86), compared as T2D, suboptimal, inequalities on presentation comorbidities. Quality improvement requires linked data collection, monitoring action diseases.

Language: Английский

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Treatment pattern trends of medications for type 2 diabetes in British Columbia, Canada

BMJ Open Diabetes Research & Care, Journal Year: 2022, Volume and Issue: 10(6), P. e002995 - e002995

Published: Nov. 1, 2022

Several new oral drug classes for type 2 diabetes (T2DM) have been introduced in the last 20 years accompanied by developments clinical evidence and guidelines. The uptake of therapies contemporary use blood glucose-lowering drugs has not closely examined Canada. objective this project was to describe these treatment patterns relate them changes provincial practice guidelines.We conducted a longitudinal utilization study among persons with T2DM aged ≥18 from 2001 2020 British Columbia (BC), We used dispensing data community pharmacies linkable physician billing hospital admission records. Laboratory results were available 2011 onwards. identified incident users drugs, then determined sequence medications dispensed, stratification age group, subgroup analysis patients history cardiovascular disease.Among cohort 362 391 (mean 57.7 old, 53.5% male) treated non-insulin-dependent diabetes, proportion who received metformin monotherapy as first-line reached maximum 90% 2009, decreasing 73% 2020. starting two-drug combinations nearly doubled 3.3% 6.4%. Sulfonylureas preferred class second-line agents over course period. In 2020, sodium-glucose cotransporter inhibitors glucagon-like peptide-1 receptor agonists accounted 21% 10% prescribing, respectively. For baseline glycated hemoglobin (A1C) prior initiating diabetic treatment, 41% had value ≤7.0% 27% 8.5%.Oral medication changed significantly BC, primarily terms therapy. Over 40% laboratory initiated an A1C ≤7.0%, average trending lower decade.

Language: Английский

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Risk factors, outcomes and healthcare utilisation in individuals with multimorbidity including heart failure, chronic kidney disease and type 2 diabetes mellitus: a national electronic health record study

Open Heart, Journal Year: 2023, Volume and Issue: 10(2), P. e002332 - e002332

Published: Sept. 1, 2023

Heart failure (HF), type 2 diabetes (T2D) and chronic kidney disease (CKD) commonly coexist. We studied characteristics, prognosis healthcare utilisation of individuals with two these conditions.We performed a retrospective, population-based linked electronic health records study from 1998 to 2020 in England identify diagnosed of: HF, T2D or CKD. described cohort characteristics at time second diagnosis estimated risk developing the third condition mortality using Kaplan-Meier Cox regression models. also rates primary care hospital settings follow-up.We identified cohorts 64 226 CKD 82 431 T2D, 13 872 HF T2D. Compared those had more severe factor profile. At 5 years, incidence all-cause occurred 37% (95% CI: 35.9%, 38.1%%) 31.3% (30.4%, 32.3%) HF+T2D, 8.7% (8.4%, 9.0%) 51.6% (51.1%, 52.1%) HF+CKD, 6.8% (6.6%, 7.0%) 17.9% (17.6%, 18.2%) CKD+T2D, respectively. In each three multimorbid groups, order first diagnoses was associated prognosis. multivariable analyses, we factors for mortality, such as age, sex, medical history diagnosis. Inpatient outpatient were highest lowest T2D.HF, carry significant burden combination. other pairs, most profile, utilisation. Service planning, policy prevention must take into account monitor data across conditions.

Language: Английский

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Challenges and Strategies in Implementing Novel Kidney Protective and Cardioprotective Therapies in Patients With Diabetes and Kidney Disease

Seminars in Nephrology, Journal Year: 2024, Volume and Issue: 44(2), P. 151520 - 151520

Published: March 1, 2024

Language: Английский

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