Influence of metabolism-related comorbidities and insulin resistance on new onset of chronic kidney disease in a health check-up population: a two-stage retrospective cohort study
Main finding · New-onset CKD per higher eGDRResult — go to the resultHazard ratio 0.88 95% CI 0.82–0.96Authors' conclusion
IR is independently linked to new-onset CKD, with blood glucose, blood pressure, and arterial stiffness mediating this relationship. These findings underscore the importance of managing IR and metabolic comorbidities to prevent CKD onset in at-risk populations.
Study context
- Population
- Health check-up participants at the Chinese People's Liberation Army General Hospital (2009–2021)13,738 in longitudinal analysis
- Participants
- 83,346 participants
- Exposure
- Higher vs lower estimated glucose disposal rate (eGDR)
- Outcome
- New-onset CKD
Methodological detailstwo-stage, cross-sectional and longitudinal analyses, single-centre
- Two-stage
- Cross-sectional and longitudinal analyses
- Single-centre
Main finding
New-onset CKD per higher eGDR · mean time to endpoint 2.95±2.02 years
Hazard ratio
0.88
95% CI 0.82–0.96
P = 0.002 for trend
Higher eGDR
HR 0.88 (95% CI 0.82–0.96); P for trend = 0.002
Per higher eGDR, as printed
As reported in the abstract
- New-onset chronic kidney disease (CKD) cases
- 403 (2.93%)
- Linear correlation between eGDR and new-onset CKD
- P < 0.001
Observational data: associations, not effects.
Further findings
Prior CKD prevalence (cross-sectional)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Higher eGDR | 0.91 (0.89–0.93) | P for trend < 0.001 | |
| 0.512Odds ratio (log scale) |
| Outcome | Non-CKD | CKD | P value |
|---|---|---|---|
| eGDR (cross-sectional)Higher in non-CKD | 9.16 ± 2.11 | 7.19 ± 2.32 | P < 0.001 |
- Prior CKD prevalence (cross-sectional) — Prior CKD
- 6.77% (n=5643)
Mediation of eGDR–new-onset CKD association (indirect effects)
- DM
- 17.1%
- Systolic blood pressure
- 22.0%
- HbA1c
- 11.1%
- Brachial-ankle pulse wave velocity
- 9.7%
- All p<0.05
Original publication
Influence of metabolism-related comorbidities and insulin resistance on new onset of chronic kidney disease in a health check-up population: a two-stage retrospective cohort study. BMJ Open Diabetes Res Care. Published 27 July 2025. doi:10.
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