Incidence and risk factors for chronic kidney disease in individuals with type 1 diabetes: A population‐based study in Salford, Manchester
Authors' conclusion
This large UK cohort study highlights a high burden of CKD among adults with T1D. Key risk factors included older age, higher BMI, poor glycaemic control, smoking and deprivation. Although ACE inhibitors and ARBs were commonly prescribed, the uptake of newer reno-protective treatments was low. These findings point to a need for earlier detection, targeted interventions and broader implementation of effective therapies to reduce kidney disease burden in this population.
Study context
- Population
- Adults with T1D, Salford Integrated Record Research Database (Salford, Greater Manchester), 2010–2023
- Participants
- 1,106 adults
- Exposure
- Demographic and clinical risk factors for chronic kidney disease (CKD)
- Outcome
- CKD incidence: eGFR <60 mL/min/1.73 m² and/or albuminuria (urine albumin-to-creatinine ratio ≥3 mg/mmol), confirmed by two readings ≥90 days apart
Methodological detailspopulation-based, competing risk regression (death as competing event)
- Population-based
- Competing risk regression (death as competing event)
Main finding
As reported in the abstract
Developed reduced estimated glomerular filtration rate (eGFR)
38.5%
Had albuminuria
47.2%
Met both criteria for CKD
23.8%
Observational data: associations, not effects.
Further findings
| Outcome | sHR (95% CI) | |
|---|---|---|
| Risk factors for reduced eGFRAge 42-54 yearsvs Age 18-28 years | 3.1 (2.0–5.0) | |
| Risk factors for reduced eGFRAge ≥55 yearsvs Age 18-28 years | 8.6 (5.4–13.9) | |
| 0.050.21520Subdistribution hazard ratio (log scale) |
- Risk factors for reduced eGFR — Missing ethnicity data, sHR
- 1.5
- Risk factors for reduced eGFR — Higher body mass index (BMI), sHR per kg/m²
- 1.1
- Risk factors for reduced eGFR — Higher HbA1c, sHR per mmol/mol
- 1.1
- Risk factors for reduced eGFR — Not prescribed ACE inhibitor or ARB, sHR
- 1.4
Risk factors for albuminuria
- Female sex, sHR
- 1.3
- Missing ethnicity, sHR
- 1.4
- Higher HbA1c, sHR
- 1.1
- Current smoking, sHR
- 1.5
- Second most deprived quintile, sHR
- 1.9
- Prescribed ACE inhibitors or ARBs, sHR
- 2.1
Original publication
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