Skip to main content
PMC home page
Diabetology & Metabolic Syndrome logoLink to Diabetology & Metabolic Syndrome
. 2023 Nov 28;15:245. doi: 10.1186/s13098-023-01202-x

Prevalence and predictors of chronic kidney disease among type 2 diabetic patients worldwide, systematic review and meta-analysis

Eneyew Talie Fenta 1,✉, Habitu Birhan Eshetu 2, Natnael Kebede 3, Eyob Ketema Bogale 4, Amare Zewdie 5, Tadele Derbew Kassie 6, Tadele Fentabil Anagaw 4, Elyas Melaku Mazengia 6, Sintayehu Shiferaw Gelaw 6
PMCID: PMC10683270  PMID: 38012781

Abstract

Background

Diabetes is a complicated, chronic condition that requires ongoing medical attention as well as multiple risk-reduction measures beyond glucose control. The prevalence of chronic kidney disease (CKD) is highly variable in different parts of the world due to various environmental, ethnic, socioeconomic, and rural-urban differences. Diabetes is the leading cause of CKD. This study aimed to estimate the global prevalence of CKD and its associated factors among type 2 diabetes(T2DM) patients, provide scientific evidence for a better understanding of the burden of CKD among diabetes mellitus type 2 patients, and design interventional strategies.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was followed for this review and meta-analysis. The electronic databases (Pub Med, Cochrane Library, Google Scholar, and grey literature) were searched to retrieve articles by using keywords. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to assess the quality of studies. The meta-analysis was conducted using STATA 17 software. The Meta logistic regression was computed to present the pooled prevalence and Odds ratio (OR) of the determinate factors with a 95% confidence interval (CI).

Results

In this systematic review and meta-analysis 20 studies were done in 13 different countries. The pooled magnitude of chronic kidney disease among type 2 DM patients was 27% (95% CI 21%, 33%). The prevalence of chronic kidney disease differs across countries, with the maximum in the USA and the lowest in the United Arab Emirates. Patients with CKD have an elevated risk of severe renal and cardiovascular morbidity and mortality. Renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and, more recently, non-steroidal mineralocorticoid receptor antagonists are among the medications that have been demonstrated to slow the progression of CKD. In this systematic review and meta-analysis increased age, obesity, having a history of type 2 diabetes mellitus, smoking history, presence of hypertension, and cardiac heart disease were factors significantly associated with the presence of chronic kidney disease among type 2 diabetic patients.

Conclusions

The prevalence of chronic kidney disease among type 2 diabetes mellitus patients was high based on the included 20 articles. The review reported that old age, hypertension, cardiac disease, smoking, obesity, and duration of diabetes mellitus was predictor variable for chronic kidney disease among type 2 diabetic patients. Therefore, in order to lower the morbidity and mortality from chronic kidney disease among type 2 diabetic patients, it is advised to develop both preventive and curative intervention strategies, such as raising awareness, creating a supportive environment, and prescribing appropriate medication at an early stage.

Keywords: Chronic kidney disease, Meta-analysis, Type 2 diabetes mellitus

Introduction

Diabetes mellitus (DM) is a metabolic systemic multifactorial disease, where the body becomes unable to utilize or produce a sufficient amount of insulin to match the body’s needs [1, 2]. Diabetes is a complicated, chronic condition that need for ongoing medical attention as well as multiple risk-reduction measures beyond glucose control [3, 4]. The World Health Organization(WHO) placed the global targets for diabetes mellitus by 2030, 80% of people living with diabetes mellitus are diagnosed, and that 80% of those living with diabetes mellitus will have good control of glycaemia and blood pressure [5].

Globally, about one in eleven adults have diabetes mellitus, from this 90% have type 2 diabetes mellitus. The main drivers of the T2DM epidemic are the global rise in obesity, sedentary lifestyles, high caloric diets and population aging, which have quadrupled the incidence and prevalence of T2DM [6–8].The estimated global prevalence of diabetes in 2015 was 415 million; by 2040, it is expected to rise to 642 million, with more increase in low- and middle-income nations [9]. DM patients have uncontrolled blood sugar levels and a longer duration of diabetes were considered as independent risk factors of CKD [10]. Diabetes can cause serious health problems, such as heart disease, stroke, and eye and foot problems. Prediabetes also can cause health problems. The good news is that type 2 diabetes can be delayed or even prevented [11].

The studies showed that diabetic individuals develop CKD and exposed to renal complications with considerable morbidity, poor quality of life, and increased healthcare costs [12–14]. The study in Europe stated that the prevalence of CKD in patients with diabetes is expected to increase within increase in cost of treatment [15]. The prevalence of CKD is highly variable in different parts of the world, due to various environmental, ethnic, socioeconomical, and rural-urban variations [16]. In the 2015 Global Burden of Disease Study, kidney disease was the 12th most common cause of death, accounting for 1.1 million deaths worldwide. Overall CKD mortality has increased by 31.7% over the last 10 years, making it one of the fastest rising major causes of death, alongside diabetes and dementia [17].

Chronic kidney disease (CKD) is the abnormalities of kidney structure or function that are present for more than 3 months characterized by low estimated glomerular filtration rate (eGFR) based on serum creatinine measurements. It is one of the complications among T2DM patients [12, 18]. The primary issue for individuals in stages 1 and 2 was that it was asymptomatic at first; metabolic abnormalities were apparent in stages 3 through 5. Diabetic kidney disease (CKD) and other vascular disorders are the main reasons. Estimating the glomerular filtration rate (eGFR), which evaluates kidney function, and finding albuminuria, a sign of kidney damage, are the first steps in diagnosing chronic kidney disease (CKD) [2, 19, 20].

All individuals with T2DM should be screened for CKD using the spot urine albumin-to-creatinine ratio and estimated glomerular filtration rate at the time of diagnosis and at least once a year after that. Although the exact cause of chronic kidney disease (CKD) is still unknown, research has shown that a number of risk factors, including obesity, ageing, hypertension, diabetes mellitus, hyperlipidemia, use of nephrotoxic medications, family history of kidney disease, smoking, heavy drinking, HIV infection, electrolyte and acid-base disturbances, low-income occupation, use of traditional medication, low hemoglobin, rapid urbanization, physical inactivity, and rapid population growth [21–25].

The study in Japan revealed that elderly patients with type 2 diabetes, renal dysfunction is characterized by low eGFR [26]. One of the main challenges of diagnosing CKD in diabetic patients is that it is asymptomatic onset with reduced quality of life, high morbidity and mortality rate [2, 27].

CKD is estimated to affect 50% patients with T2DM globally, and its presence and severity markedly influences disease prognosis. CKD is more common in certain patient populations, including the elderly, those with youth-onset diabetes mellitus, those who are obese, certain ethnic groups, and disadvantaged populations. The incident cases of CKD as a result of type 2 diabetes mellitus worldwide in 2017 had increased by 74% compared with 1990 [28–30].The study showed that prevalence of CKD ranged from 11 to 90% in patients with diabetes, high-risk groups in patients with HIV from 1–46%,and 13–51% in patients with hypertension [31].

In order to improve patients’ quality of life, early screening for CKD is crucial for diagnosis and treatment. Other interventions include counselling, good glycemic and blood pressure control, and medication use. Renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and, more recently, non-steroidal mineralocorticoid receptor antagonists are among the medications that have been demonstrated to slow the progression of CKD [24, 32–34].

Diabetes is the leading cause of CKD in all developed and most developing countries, with approximately 20% of people with type 2 diabetes showing evidence of diabetic nephropathy within 20 years of diabetes onset [35]. The patients with diabetes are likely to be prescribed more than one type of medication which exposed them at a higher risk of CKD due to the effect of polypharmacy [36, 37]. Studies showed that early detection and treatment of diabetes and chronic diseases can slow or prevent the progression of CKD [38] .This study aimed to estimate the global prevalence of CKD and its associated factors among type 2 diabetes patients that can provides a scientific evidence for a better understanding of the burden of CKD among type 2 diabetes mellitus patients and design interventional strategies.

Methodology

Search strategy

This systematic review and meta-analysis was performed by following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [39]. A search strategy was implemented using electronic databases (PubMed, Cochrane Library, Google Scholar, and grey literature), which were systematically searched online to retrieve related articles. The literature search was conducted by using the key words “chronic kidney disease” OR (chronic renal failure) AND “Type 2 diabetes mellitus” OR “T2DM starting from May 30, 2018 to May 30, 2023 were included. The retrieved studies references were also screened and checked. The review protocol is available on PROSPERO (ID: CRD42023433892).

Eligibility criteria

For the review, CoCoPop mnemonic (Condition, Context and Population) approach was used. Studies that reported chronic kidney disease prevalence and associated factors among type 2 diabetic patients globally with any type of study design at any health facility level, studies with open or free access to full text and written in English language were included. The studies without abstract & full-text, reports, and qualitative studies, conference summaries were excluded. Articles were assessed for inclusion using their title, abstract and then a full review of articles was done before included to the final review.

Data extraction and management

Eligible studies were imported to Endnote v.9 and duplicates were removed. The two independent reviewers (TFA, EKB,) were do the abstract and full text review and data abstraction. Any disagreements were resolved by consensus and involvement of third reviewer (ETF). Full text articles were retrieved for studies that meet the inclusion criteria. Data extraction used a data collection form and was performed by two blind and independent reviewers. The following data were extracted: author, publication year, study design, place of study, sample size, participants.

Quality assessment

The Joanna Briggs Institute (JBI) critical appraisal check list was used to assess the quality of studies which is freely available at https://jbi.global/critical-appraisal-tools. Using the tool as a protocol, the reviewers (NK, SSG) used the blinded review approach to evaluate the quality of the original articles. Those studies, scores 5 or more in JBI criteria were considered to have good quality and included in the review [40]. Discrepancies in the quality assessment was resolved through a third author (EMM).

Statistical analysis

The necessary data were extracted from the studies using Microsoft Excel V.2016 and the extracted data were exported to STATA version 17 software for analysis. The articles were summarized by tables and forest plot. The standard error and 95% confidence interva1 for the prevalence of chronic kidney disease was calculated for those studies in which estimates of standard error and 95% confidence interval for the prevalence of chronic kidney disease were not found in their full text of their article.

Meta-analysis was performed, the significance of the pooled Odds Ratio (OR) was determined by Z-test. The pooled estimate for the prevalence of CKD in patients with diabetes was calculated using random-effect models with 95% confidence intervals (CIs). The statistical heterogeneity was checked subjectively by using forest plot, and objectively by Cochrane Q-test and I2 statistics [41]. The presence of publication bias was checked by using a funnel plot and Egger’s and Begg’s statistical tests [42].

Results

In this systematic review and meta-analysis, a total of three thousand two hundred seventy-eight (3,278) record articles were searched from all searched database sources. After removing duplicates (3176), reviewing title and abstract (102), and removal of 39 articles due to not reporting for prevalence of chronic disease among diabetes mellitus type 2 patients, then 63 articles were eligible for full text review and finally 20 articles included for systematic review and meta-analysis (Fig. 1).

Fig. 1.

Fig. 1

Open in a new tab

PRISMA flow diagram of study selection

Study characteristics

In this systematic review and meta-analysis 20 studies were done in 13 different countries globally. Two studies done in Ethiopia [43, 44],one study each in Ghana [45], United Arab Emirates [46], Australia [47], Germen [48], united kingdom, Malaysia, Palestine [49–51], three studies in USA [52–54] ,two in China [55, 56],two in Spain [57, 58], three in Thailand [59–61], and in six countries in Europe and Asia [62].in this study most of the studies were hospital based except two are community level. The total sample size was 1,711,926 with maximum sample 1, 177 896 sample in six European and Asian countries [62] and minimum of 119 sample size in Ethiopia [44] (Table 1).

Table 1.

Characteristics of studies included in the systematic review and meta-analysis of the magnitude of chronic kidney disease among type 2 Dm patients worldwide

Authors/ publication year Region Study design Study setting Sample size Prevalence of CKD (%) Quality assessment based on JBI
Anunya Pradidthaprecha, et,al (2021)[50] Thailand retrospective hospital based 3,465 29.70% 9
Junlin Zhang etal(2022)[39] USA retrospective hospital based 2720 35.06% 8
Janjira Jitraknatee etal/2020[49] Thailand cross-sectional primary care 1,096 24.40% 8
Sojib Bin Zaman etal/2018[51] Thailand retrospective district hospital 3,580 23.26% 6
Ruth Usó-Talamantes etal.2021[48] Spain cross-sectional Spanish Health District 14,935 33.80% 9
Juan,Martínez Candelaa.etal/2018[47] Spain cross-sectional Primary Care 939 37.20% 8
Zaher Nazzal.etal/2020[42] Palestine cross-sectional PHC clinics 385 23.60% 7
Ruth Sim etal./2023 [41] malasiya cross-sectional two tertiary hospitals 1992 15% 6
Kåre I. Birkeland MD etal/2020[52] Europe and Asia cross-sectional population-based study 1, 177 896 36% 6
Medina Abdela Ahmed etal/2022[33] Ethiopia retrospective Referral hospitals 415 10.80% 8
Petter Bjornstad, M.D.,etal/2021[43] USA prospective Hospital based 500 54.80% 6
 S Al-Shamsi et al. /2018[36] United Arab Emirates retrospective two public hospitals 251 37.70% 7
Lin Yang etal/2018[46] China prospective primary care setting 31,574 29.70% 9
Jiayu Duan1etal/2019[45] China prospective rural districts 2710 35.50%
Shewaneh Damtie1etal/2018[34] Ethiopia cross-sectional hospital based 119 3.751 8
Elliot K. Tannor, MD et al. /2019[35] Ghana cross-sectional hospital based 348 16.10% 8
Antonio González-Pérez etal/2019[40] UK Cohort hospital based 109,365 26% 7
Louisa Sukkar etal/2020[37] Australia prospective population-based 9,313 22.60% 6
Peter Bramlage1 et al. 2019[38] Germany cross-sectional hospital based 343,675 50% 9
Darren K. McGuire MD etal/ 2023 [44] USA randomized controlled hospital based 9650 42.3% 7
Open in a new tab

Meta -analysis

Pooled prevalence of chronic Kidney Disease among type 2 DM patients

The pooled magnitude chronic kidney disease among type 2 DM patients was 27% (95% CI 21%, 33%). Based on tau square (between studies variance), tau2 = 25252.96 & I2 = 99.8 with p value < 0.00005 which indicates there is statistically significant heterogeneity among studies (Fig. 2).

Fig. 2.

Fig. 2

Open in a new tab

Forest plot of the pooled magnitude of CKD among type 2 diabetes mellites patients

Publication bias

The result of regression-based egger test for small-study effects showed significant result (p value = 0.2540). The funnel plot’s evidence suggests the current study had a source of publication bias. The results seemed like asymmetrical funnel plots. The result of egger’s test was not statistically significant for the presence of publication bias (P = 0.254). and Begg’s test for small-study effects was significant (p = 0.0012) (Fig. 3).

Fig. 3.

Fig. 3

Open in a new tab

 A funnel plot displaying publication bias across the studies

Factors associated with CKD among type 2 diabetic patients

In this systematic review and meta-analysis increased age, obesity, duration of diabetes mellitus, smoking history, presence of hypertension, and having cardiac heart disease were factors significantly associated with the presence chronic kidney disease among type 2 diabetic patients. Eleven studies had shown the association between increased age and he development of CKD among type 2 diabetic patients. The pooled odds ratio showed that diabetics patients with increased age were 24 times more likely to develop CKD than those with younger (AOR = 24, 95 CI, (0.11–0.37) (Fig. 4). Four studies revealed that having history of type 2 diabetics has 33 times increased risk of CKD than non-diabetics patients (AOR = 33,95 CI, (0.18–0.48) (Fig. 5).

Fig. 4.

Fig. 4

Open in a new tab

Association between age and chronic kidney disease among type 2 DM patients

Fig. 5.

Fig. 5

Open in a new tab

Association between history of type 2 DM and chronic kidney disease among type 2 DM patients

Five studies reported that having cardiac disease with DM has 11 times More likely to develop CKD than without. (AOR = 11,95 CI, (0.7 − 0.14) (Fig. 6). Two studies showed that being obesity has 15 times more likely CKF than normal. AOR = 15,95 CI, (0.14–0.16)) (Fig. 7).

Fig. 6.

Fig. 6

Open in a new tab

Association between having cardiac and chronic kidney disease among type 2 DM patients

Fig. 7.

Fig. 7

Open in a new tab

Association between obesity and chronic kidney disease among type 2 DM patients

Four studies describe that smokers were 13 times more likely to develop CKD than non-smokers (AOR = 13,95 CI, (0.11–0.14) (Fig. 8). Nine studies discussed that having hypertension was 13 times more likely to get CKD than non-hypertensive DM patients (AOR = 13,95 CI, (0.05–0.21) (Fig. 9).

Fig. 8.

Fig. 8

Open in a new tab

Association between smoking and chronic kidney disease among type 2 DM patients

Fig. 9.

Fig. 9

Open in a new tab

Association between hypertension and chronic kidney disease among type 2 DM patients

Discussion

Chronic kidney disease is associated with several consequences, including anemia, bone and mineral disorders, electrolyte imbalance, acid-base abnormalities, sexual dysfunction, hypertension, cardiovascular diseases [63]. Globally 850 million individuals live with the chronic kidney disease with all-age prevalence of 29.3% [64, 65]. Type 2 diabetes, hypertension, and glomerulonephritis are the most frequent underlying diseases that lead to the development of CKD. Patients with CKD have an elevated risk of severe renal and cardiovascular morbidity and mortality [66–68].

Among the drugs that have been shown to slow the progression of chronic kidney disease are glucagon-like peptide 1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, renin-angiotensin system inhibitors, and, more recently, non-steroidal mineralocorticoid receptor antagonists. Neither an ACE inhibitor nor an angiotensin receptor blocker is recommended for the primary prevention of chronic kidney disease in diabetics with normal blood pressure, urine albumin-to-creatinine ratio (< 30 mg/g creatinine), and normal estimated glomerular filtration rate. For people with type 2 diabetes and diabetic kidney disease, it is recommended to use a sodium-glucose cotransporter 2 inhibitor to slow the progression of cardiovascular events and chronic kidney disease in patients with estimated glomerular filtration rate ≥ 20 mL/min/1.73 m2 and urinary albumin ≥ 200 mg/g creatinine [18, 36, 69].

End-stage renal disease (ESRD) resulting from diabetic kidney disease has a number of systemic effects that lower quality of life, including electrolyte abnormalities, problems with bone metabolism, and renal anemia. Comprehensive care of hyperglycemia, hypertension, dyslipidemia, and healthy lifestyle choices is typically provided to those with diabetes and chronic kidney disease [70–72]. Approximately 40% of those with type 2 diabetes will develop CKD, and the risk rises with the duration of the disease. When compared to costs for people with diabetes alone, having CKD results in an average increase in healthcare costs of over 50% [73, 74].

The goal of this systematic review and meta-analysis was to generate pooled estimates of the prevalence of chronic kidney disease among individuals who have type 2 diabetes mellitus globally. Based on the review the prevalence of chronic kidney disease among type 2 diabetes mellites was 27% (95% CI 21%, 33%).This was comparable with systematic review and meta-analysis study in Africa, which reported 24.7% pooled prevalence of CKD [75],in the middle east region the prevalence of CKD was 28.96% [76], Iran prevalence of nephropathy in patients with type 2 diabetes was 30.6% [77], in Asia the prevalence of CKD was 31% in adults with DM [78], and another systematic review and meta-analysis which include cohort studies in Europe, Asia and America report the prevalence of CKD among T2DM was approximately 29.1% [79].

This systematic review and meta-analysis was lower than study reported a pooled prevalence of end stage renal disease was 73% [80] and in sub Saharan Africa the overall prevalence of diabetic nephropathy was 35.3% [81] and the study was higher than the study in Africa among the general population which was 15.8% [82], In Asia the pooled prevalence of CKD among the general population was 14% [78],another cohort systematic review and meta-analysis reported that ESRD among on T2DM was 1.1% [83]. The discrepancy could be differences in study period, sample size, demographics characteristics, diabetic duration, and study design of included studies.

This systematic review and meta-analysis include 20 studies in 13 countries with total 1,711,926 study participants. According to the review, USA had the highest incidence of CKD at 54.8% and the United Arab Emirates had the lowest prevalence at 4% [46, 52]. The funnel plot’s evidence the results seemed like asymmetrical funnel plots suggests current study had a source of publication bias. but the result of egger’s test was not statistically significant for the presence of publication bias (P = 0.254).

The study revealed that being old age, hypertension, cardiac disease, smoking, obesity, having type 2 diabetes mellitus was predictor variable for presence of chronic kidney disease among type 2 diabetic patients. This was consistent with the study reported that age, smoking, and DM duration has significant association with CKD development among diabetic patient [83].Another systematic review showed that duration of diabetics and having hypertension and obesity has increased risk of chronic kidney disease among diabetic patients [81, 84, 85]. The study in China also showed that old age, smoking, and hypertension were predictor variables of CKD with increased morbidity and mortality in T2DM patients [86].

Conclusion

This systematic review and meta-analysis revealed that the prevalence of chronic kidney disease among type 2 diabetes mellites patients was high based on the included 20 articles. The prevalence of chronic kidney disease varies across country with the highest in USA and the lowest in Ethiopia. The review reported that old age, hypertension, having cardiac disease, smoking, obesity, having history of type 2 diabetes mellitus were predictor variables for chronic kidney disease among diabetic patients. Patients with CKD have an elevated risk of severe renal and cardiovascular morbidity and mortality. Therefore, in order to lower the morbidity and mortality from chronic kidney disease among type 2 diabetic patients, it is advised to develop both preventive and curative intervention strategies, such as raising awareness, creating a supportive environment and prescribing appropriate medication at an early stage.

Authors’ contributions

ETF, TFA, EKB, ZA, and SSG search and extract the articles, TDK, TFA EMM, and HBE check the quality of the articles, NK, EKB, ETF, ZA, and TFA do the analysis part and write the result, ZA,TDK, TFA EMM, and HBE review the manuscript. ETF, TFA, EKB, and SSG revised the manuscript. Finally,all authors gave approval of the version to be published; agreed on the journal to which the article had been submitted; and agreed to be accountable for all aspects of the work.

Funding

This study was not funded by any organization.

Declarations

Ethical approval

Not applicable.

Competing interests

The authors declare no competing interests.

Data Availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Disclosure

The authors declare that they have no competing interests.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

  • 1.Goyal R, Jialal I. Diabetes Mellitus Type 2: StatPearls Publishing, Treasure Island (FL); 2022; 2022.
  • 2.Levey AS. Coresh JJTl. Chronic Kidney Disease. 2012;379(9811):165–80. doi: 10.1016/S0140-6736(11)60178-5. [DOI] [PubMed] [Google Scholar]
  • 3.Poretsky L. Principles of Diabetes Mellitus. Springer; 2010.
  • 4.Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB et al. Pathophysiology of type 2 Diabetes Mellitus. 2020;21(17):6275. [DOI] [PMC free article] [PubMed]
  • 5.Cheng AY, Gomes MB, Kalra S, Kengne A-P, Mathieu C, Shaw JEJNRE. Applying the WHO global targets for diabetes mellitus. 2023:1–7. [DOI] [PubMed]
  • 6.Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 Diabetes Mellitus and its Complications. Nat Rev Endocrinol. 2018;14(2):88–98. doi: 10.1038/nrendo.2017.151. [DOI] [PubMed] [Google Scholar]
  • 7.Ginter E. Simko VJDaod, a new insight. Type 2 diabetes mellitus, pandemic in 21st century. 2013:42–50. [DOI] [PubMed]
  • 8.Zhou B, Lu Y, Hajifathalian K, Bentham J, Di Cesare M, Danaei G et al. Worldwide trends in Diabetes since 1980: a pooled analysis of 751 population-based studies with 4· 4 million participants. 2016;387(10027):1513–30. [DOI] [PMC free article] [PubMed]
  • 9.Atlas DJIDA. Brussels, Belgium: International Diabetes Federation. Int Diabetes Federation. 2015;33:2. [Google Scholar]
  • 10.Shen Y, Cai R, Sun J, Dong X, Huang R, Tian S et al. Diabetes Mellitus as a risk factor for incident chronic Kidney Disease and end-stage renal Disease in women compared with men: a systematic review and meta-analysis. 2017;55:66–76. [DOI] [PubMed]
  • 11.Rasooly RS, Akolkar B, Spain LM, Guill MH, Del Vecchio CT, Carroll LEJCJotASoN. The National Institute of Diabetes and Digestive and kidney Diseases Central repositories: a valuable resource for nephrology research. 2015;10(4):710–5. [DOI] [PMC free article] [PubMed]
  • 12.Alicic RZ, Rooney MT, Tuttle, KRJCjotASoN. Diabetic Kidney Disease: challenges, progress, and possibilities. 2017;12(12):2032–45. [DOI] [PMC free article] [PubMed]
  • 13.Heo GY, Koh HB, Kim HW, Park JT, Yoo T-H, Kang S-W, et al. Glycemic control and adverse clinical outcomes in patients with chronic Kidney Disease and type 2 Diabetes Mellitus. Results from KNOW-CKD; 2023. [DOI] [PMC free article] [PubMed]
  • 14.Chung H, Crowe CL, Kong SX, Singh R, Farej R, Elliott J et al. Descriptive study of the economic burden among patients with type 2 Diabetes Mellitus, chronic Kidney Disease, and chronic Kidney Disease and type 2 Diabetes Mellitus in a large US commercially insured population. 2023;29(1):80–9. [DOI] [PMC free article] [PubMed]
  • 15.Kainz A, Hronsky M, Stel VS, Jager KJ, Geroldinger A, Dunkler D et al. Prediction of prevalence of chronic Kidney Disease in diabetic patients in countries of the European Union up to 2025. 2015;30(suppl_4):iv113–iv8. [DOI] [PubMed]
  • 16.Imtiaz S, Salman B, Qureshi R, Drohlia MF, Ahmad AJSJoKD. Transplantation. A review of the epidemiology of chronic Kidney Disease in Pakistan: a global and regional perspective. 2018;29(6):1441–51. [DOI] [PubMed]
  • 17.Neuen BL, Chadban SJ, Demaio AR, Johnson DW, Perkovic V. Chronic Kidney Disease and the global NCDs agenda. 2017;2(2):e000380. [DOI] [PMC free article] [PubMed]
  • 18.Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic Kidney Disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139(2):137–47. doi: 10.7326/0003-4819-139-2-200307150-00013. [DOI] [PubMed] [Google Scholar]
  • 19.Levey AS, Becker C, Inker LAJJ. Glomerular filtration rate and albuminuria for detection and staging of acute and chronic Kidney Disease in adults: a systematic review. 2015;313(8):837–46. [DOI] [PMC free article] [PubMed]
  • 20.Valmadrid CT, Klein R, Moss SE, Klein BEJA. The risk of Cardiovascular Disease mortality associated with microalbuminuria and gross proteinuria in persons with older-onset Diabetes Mellitus. 2000;160(8):1093–100. [DOI] [PubMed]
  • 21.Chen W, Chen W, Wang H, Dong X, Liu Q, Mao H et al. Prevalence and risk factors associated with chronic Kidney Disease in an adult population from southern China. 2009;24(4):1205–12. [DOI] [PMC free article] [PubMed]
  • 22.Chukwuonye II, Ogah OS, Anyabolu EN, Ohagwu KA, Nwabuko OC, Onwuchekwa U et al. Prevalence of chronic kidney disease in Nigeria: systematic review of population-based studies. 2018:165 – 72. [DOI] [PMC free article] [PubMed]
  • 23.Ephraim RK, Biekpe S, Sakyi SA, Adoba P, Agbodjakey H, Antoh EOJC et al. Prevalence of chronic Kidney Disease among the high risk population in South-Western Ghana; a cross sectional study. 2015;2:76. [DOI] [PMC free article] [PubMed]
  • 24.Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. 2003;139(2):137 – 47. [DOI] [PubMed]
  • 25.Moosa M, Van der Walt I, Naicker S, Meyers AJSA. Important causes of chronic Kidney Disease in South Africa. 2015;105(4):320–7. [DOI] [PubMed]
  • 26.Takamatsu KJC, Nephrology E. Renal status in elderly patients with type 2 Diabetes. 2020;24:53–62. [DOI] [PMC free article] [PubMed]
  • 27.Wyld ML, Morton RL, Clayton P, Wong MG, Jardine M, Polkinghorne K et al. The impact of Progressive chronic Kidney Disease on health-related quality-of-life: a 12-year community cohort study. 2019;28:2081–90. [DOI] [PubMed]
  • 28.Thomas MC, Cooper ME, Zimmet PJNRN. Changing epidemiology of type 2 Diabetes Mellitus and associated chronic Kidney Disease. 2016;12(2):73–81. [DOI] [PubMed]
  • 29.Li H, Lu W, Wang A, Jiang H, Lyu JJJ. Changing epidemiology of chronic Kidney Disease as a result of type 2 Diabetes Mellitus from 1990 to 2017: estimates from global burden of Disease 2017. 2021;12(3):346–56. [DOI] [PMC free article] [PubMed]
  • 30.Saran R, Robinson B, Abbott KC, Agodoa LY, Albertus P, Ayanian J, et al. Epidemiol kidney disease United States. 2017;69(3):A7–A8. US renal data system 2016 annual data report:. [DOI] [PMC free article] [PubMed]
  • 31.ElHafeez SA, Bolignano D, D’Arrigo G, Dounousi E, Tripepi G, Zoccali C. Prevalence and burden of chronic Kidney Disease among the general population and high-risk groups in Africa: a systematic review. 2018;8(1):e015069. [DOI] [PMC free article] [PubMed]
  • 32.Skolnik NS, Style AJJDT. Importance of early screening and diagnosis of chronic Kidney Disease in patients with type 2 Diabetes. 2021;12(6):1613–30. [DOI] [PMC free article] [PubMed]
  • 33.Toyama T, Neuen BL, Jun M, Ohkuma T, Neal B, Jardine MJ et al. Effect of SGLT2 inhibitors on cardiovascular, renal and safety outcomes in patients with type 2 Diabetes Mellitus and chronic Kidney Disease: a systematic review and meta-analysis. 2019;21(5):1237–50. [DOI] [PubMed]
  • 34.Zelniker TA, Wiviott SD, Raz I, Im K, Goodrich EL, Furtado RH et al. Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 Diabetes Mellitus: systematic review and meta-analysis of cardiovascular outcomes trials. 2019;139(17):2022–31. [DOI] [PubMed]
  • 35.Bikbov B, Purcell C, Levey A, Smith M, Abdoli A, Abebe M et al. GBD chronic Kidney Disease collaboration: global, regional, and national burden of chronic Kidney Disease, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. 2020;395(709–733):32061315. [DOI] [PMC free article] [PubMed]
  • 36.Schmidt IM, Hübner S, Nadal J, Titze S, Schmid M, Bärthlein B et al. Patterns of medication use and the burden of polypharmacy in patients with chronic Kidney Disease: the German chronic Kidney Disease study. 2019;12(5):663–72. [DOI] [PMC free article] [PubMed]
  • 37.Alwafi H, Wei L, Naser AY, Mongkhon P, Tse G, Man KK et al. Trends in oral anticoagulant prescribing in individuals with type 2 Diabetes Mellitus: a population-based study in the UK. 2020;10(5):e034573. [DOI] [PMC free article] [PubMed]
  • 38.Eknoyan G, Lameire N, Eckardt K, Kasiske B, Wheeler D, Levin A et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic Kidney Disease. 2013;3(1):5–14.
  • 39.Okpara CV, Anselm AU, Felix TO, Omowale A, Gever VCJH. The moderating role of colour in modelling the effectiveness of COVID-19 YouTube animated cartoons on the health behaviour of social media users in Nigeria. 2021;36(6):1599–609. [DOI] [PMC free article] [PubMed]
  • 40.Masresha SA, Alen GD, Kidie AA, Dessie AA, Dejene TMJSR. First line antiretroviral treatment failure and its association with drug substitution and sex among children in Ethiopia: systematic review and meta-analysis. 2022;12(1):18294. [DOI] [PMC free article] [PubMed]
  • 41.Higgins J, Green S. Cochrane handbook for systematic reviews of interventions: cochrane book series. Cochrane handbook for systematic reviews of interventions: cochrane book series. 2008. John Wiley & Sons Location: Hoboken, New Jersy, USA; 2008.
  • 42.Sterne JA, Egger MJJ. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. 2001;54(10):1046–55. [DOI] [PubMed]
  • 43.Ahmed MA, Ferede YM, Takele WWJP. Incidence and predictors of chronic Kidney Disease in type-II Diabetes Mellitus patients attending at the Amhara region referral hospitals, Ethiopia: a follow-up study. 2022;17(1):e0263138. [DOI] [PMC free article] [PubMed]
  • 44.Damtie S, Biadgo B, Baynes HW, Ambachew S, Melak T, Asmelash D et al. Chronic Kidney Disease and associated risk factors assessment among Diabetes Mellitus patients at a tertiary hospital, Northwest Ethiopia. 2018;28(6). [DOI] [PMC free article] [PubMed]
  • 45.Tannor EK, Sarfo FS, Mobula LM, Sarfo-Kantanka O, Adu‐Gyamfi R, Plange‐Rhule JJTH. Prevalence and predictors of chronic Kidney Disease among Ghanaian patients with Hypertension and Diabetes Mellitus: a multicenter cross‐sectional study. 2019;21(10):1542–50. [DOI] [PMC free article] [PubMed]
  • 46.Al-Shamsi S, Regmi D, Govender RJP. Chronic Kidney Disease in patients at high risk of Cardiovascular Disease in the United Arab Emirates: a population-based study. 2018;13(6):e0199920. [DOI] [PMC free article] [PubMed]
  • 47.Sukkar L, Kang A, Hockham C, Young T, Jun M, Foote C et al. Incidence and associations of chronic Kidney Disease in community participants with Diabetes: a 5-year prospective analysis of the EXTEND45 study. 2020;43(5):982–90. [DOI] [PMC free article] [PubMed]
  • 48.Bramlage P, Lanzinger S, van Mark G, Hess E, Fahrner S, Heyer CH et al. Patient and Disease characteristics of type-2 Diabetes patients with or without chronic Kidney Disease: an analysis of the German DPV and DIVE databases. 2019;18(1):1–12. [DOI] [PMC free article] [PubMed]
  • 49.González-Pérez A, Saéz ME, Vizcaya D, Lind M, Rodríguez LAGJP. Impact of chronic Kidney Disease definition on assessment of its incidence and risk factors in patients with newly diagnosed type 1 and type 2 Diabetes in the UK: a cohort study using primary care data from the United Kingdom. 2020;14(4):381–7. [DOI] [PubMed]
  • 50.Sim R, Chong CW, Loganadan NK, Adam NL, Hussein Z, Lee SWHJC. Comparison of a chronic Kidney Disease predictive model for type 2 Diabetes Mellitus in Malaysia using Cox regression versus machine learning approach. 2023;16(3):549–59. [DOI] [PMC free article] [PubMed]
  • 51.Nazzal Z, Hamdan Z, Masri D, Abu-Kaf O, Hamad, MJBn. Prevalence and risk factors of chronic Kidney Disease among Palestinian type 2 diabetic patients: a cross-sectional study. 2020;21:1–8. [DOI] [PMC free article] [PubMed]
  • 52.Medicine TSGJNEJo. Long-term Complications in youth-onset type 2 Diabetes. 2021;385(5):416–26. [DOI] [PMC free article] [PubMed]
  • 53.Zhang J, Chen Y, Zou L, Gong RJAD. Prognostic nutritional index as a risk factor for diabetic Kidney Disease and mortality in patients with type 2 Diabetes Mellitus. 2023;60(2):235–45. [DOI] [PMC free article] [PubMed]
  • 54.McGuire DK, Busui RP, Deanfield J, Inzucchi SE, Mann JF, Marx N et al. Effects of oral semaglutide on cardiovascular outcomes in individuals with type 2 Diabetes and established atherosclerotic Cardiovascular Disease and/or chronic Kidney Disease: SOUL, a randomized trial, design and baseline characteristics. 2023. [DOI] [PubMed]
  • 55.Duan J, Wang C, Liu D, Qiao Y, Pan S, Jiang D et al. Prevalence and risk factors of chronic Kidney Disease and diabetic Kidney Disease in Chinese rural residents: a cross-sectional survey. 2019;9(1):10408. [DOI] [PMC free article] [PubMed]
  • 56.Yang L, Chu TK, Lian J, Lo CW, Lau PK, Nan H et al. Risk factors of chronic kidney Diseases in Chinese adults with type 2 Diabetes. 2018;8(1):14686. [DOI] [PMC free article] [PubMed]
  • 57.Candela JM, González JS, Soidán FJG, Trillo JMM, Espino JD, Bosque DB et al. Chronic renal Disease in Spain: prevalence and related factors in persons with Diabetes Mellitus older than 64 years. 2018;38(4):395–407. [DOI] [PubMed]
  • 58.Usó-Talamantes R, González-de-Julián S, Díaz-Carnicero J, Saurí-Ferrer I, Trillo-Mata JL, Carrasco-Pérez M et al. Cost of type 2 Diabetes patients with chronic Kidney Disease based on real-world data: an observational population-based study in Spain. 2021;18(18):9853. [DOI] [PMC free article] [PubMed]
  • 59.Jitraknatee J, Ruengorn C, Nochaiwong SJS. Prevalence and risk factors of chronic Kidney Disease among type 2 Diabetes patients: a cross-sectional study in primary care practice. 2020;10(1):6205. [DOI] [PMC free article] [PubMed]
  • 60.Pradidthaprecha A, Muktabhant B, Schelp FP, Tatiyanupanwong S, Thinkhamrop W, Chaichaya N. Renal Disease progression and associated factors in type 2 Diabetes patients: A retrospective cohort study.
  • 61.Zaman SB, Hossain N, Rahman MJD. journal m. Associations between body mass index and chronic kidney disease in type 2 diabetes mellitus patients: findings from the northeast of Thailand. 2018;42(4):330-7. [DOI] [PMC free article] [PubMed]
  • 62.Birkeland KI, Bodegard J, Eriksson JW, Norhammar A, Haller H, Linssen GC et al. Heart Failure and chronic Kidney Disease manifestation and mortality risk associations in type 2 Diabetes: a large multinational cohort study. 2020;22(9):1607–18. [DOI] [PMC free article] [PubMed]
  • 63.Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M et al. Global, regional, and national burden of chronic Kidney Disease, 1990–2017: a systematic analysis for the global burden of Disease Study 2017. 2020;395(10225):709–33. [DOI] [PMC free article] [PubMed]
  • 64.Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney Diseases. Nephrol Dialysis Transplantation. 2019;34(11):1803–5. doi: 10.1093/ndt/gfz174. [DOI] [PubMed] [Google Scholar]
  • 65.Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. 2020;395(10225):709–33. [DOI] [PMC free article] [PubMed]
  • 66.Xie Y, Bowe B, Mokdad AH, Xian H, Yan Y, Li T et al. Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. 2018;94(3):567 – 81. [DOI] [PubMed]
  • 67.Carpio EM, Ashworth M, Asgari E, Shaw C, Schartau P, Durbaba S et al. Hypertension and cardiovascular risk factor management in a multi-ethnic cohort of adults with CKD: a cross sectional study in general practice. 2022:1–10. [DOI] [PMC free article] [PubMed]
  • 68.Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, Cockwell P et al. Symptom burden and health-related quality of life in chronic Kidney Disease: a global systematic review and meta-analysis. 2022;19(4):e1003954. [DOI] [PMC free article] [PubMed]
  • 69.ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2023. 2023;11(Supplement1):191–S202. doi: 10.2337/dc23-S011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 70.Kohan DE, Barton M. Endothelin and endothelin antagonists in chronic Kidney Disease. Kidney Int. 2014;86(5):896–904. doi: 10.1038/ki.2014.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 71.Levey AS, Gansevoort RT, Coresh J, Inker LA, Heerspink HL, Grams ME, et al. Change in Albuminuria and GFR as End points for clinical trials in early stages of CKD: A Scientific Workshop Sponsored by the National Kidney Foundation in collaboration with the US Food and Drug Administration and European Medicines Agency. Am J Kidney Dis. 2020;75(1):84–104. doi: 10.1053/j.ajkd.2019.06.009. [DOI] [PubMed] [Google Scholar]
  • 72.Cherney DZI, Bell A, Girard L, McFarlane P, Moist L, Nessim SJ, et al. Management of type 2 Diabetic Kidney Disease in 2022: a narrative review for specialists and primary care. Can J Kidney Health Disease. 2023;10:20543581221150556. doi: 10.1177/20543581221150556. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 73.Li R, Bilik D, Brown MB, Zhang P, Ettner SL, Ackermann RT, et al. Medical costs associated with type 2 Diabetes Complications and comorbidities. Am J Manag Care. 2013;19(5):421–30. [PMC free article] [PubMed] [Google Scholar]
  • 74.International Diabetes Federation. Diabetes Atlas10th edn. https://diabetesatlas.org/en/resources.
  • 75.Abd ElHafeez S, Bolignano D, D’Arrigo G, Dounousi E, Tripepi G, Zoccali CJB. Prevalence and burden of chronic Kidney Disease among the general population and high-risk groups in Africa: a systematic review. 2018;8(1):e015069. [DOI] [PMC free article] [PubMed]
  • 76.Naser AY, Alwafi H, Alotaibi B, Salawati E, Samannodi M, Alsairafi Z et al. Prevalence of chronic kidney diseases in patients with diabetes mellitus in the Middle East: A systematic review and meta-analysis. 2021;2021. [DOI] [PMC free article] [PubMed]
  • 77.Rabieenia E, Jalali R, Mohammadi M. Prevalence of nephropathy in patients with type 2 diabetes in Iran: A systematic review and meta-analysis based on geographic information system (GIS). Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(5):1543-50. [DOI] [PubMed]
  • 78.Shrestha N, Gautam S, Mishra SR, Virani SS, Dhungana RRJP. Burden of chronic Kidney Disease in the general population and high-risk groups in South Asia: a systematic review and meta-analysis. 2021;16(10):e0258494. [DOI] [PMC free article] [PubMed]
  • 79.Jiang W, Wang J, Shen X, Lu W, Wang Y, Li W, et al. Establishment and validation of a risk Prediction Model for Early Diabetic Kidney Disease based on a Systematic Review and Meta-analysis of 20 cohorts. Diabetes Care. 2020;43(4):925–33. doi: 10.2337/dc19-1897. [DOI] [PubMed] [Google Scholar]
  • 80.Buchan TA, Malik A, Chan C, Chambers J, Suk Y, Zhu JW, et al. Predictive models for cardiovascular and kidney outcomes in patients with type 2 Diabetes: systematic review and meta-analyses. Heart. 2021;107(24):1962–73. doi: 10.1136/heartjnl-2021-319243. [DOI] [PubMed] [Google Scholar]
  • 81.Wagnew F, Eshetie S, Kibret GD, Zegeye A, Dessie G, Mulugeta H, et al. Diabetic Nephropathy and Hypertension in Diabetes patients of sub-saharan countries: a systematic review and meta-analysis. BMC Res Notes. 2018;11(1):565. doi: 10.1186/s13104-018-3670-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 82.Kaze AD, Ilori T, Jaar BG, Echouffo-Tcheugui JB. Burden of chronic Kidney Disease on the African continent: a systematic review and meta-analysis. BMC Nephrol. 2018;19(1):125. doi: 10.1186/s12882-018-0930-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 83.Ren Q, Chen D, Liu X, Yang R, Yuan L, Ding M, et al. Derivation and validation of a prediction model of end-stage renal Disease in patients with type 2 Diabetes based on a systematic review and Meta-analysis. Front Endocrinol. 2022;13:825950. doi: 10.3389/fendo.2022.825950. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 84.Tomino Y, Gohda TJKD. The prevalence and management of diabetic Nephropathy in Asia. 2015;1(1):52–60. [DOI] [PMC free article] [PubMed]
  • 85.Garofalo C, Borrelli S, Minutolo R, Chiodini P, De Nicola L. Conte GJKi. A systematic review and meta-analysis suggests obesity predicts onset of chronic Kidney Disease in the general population. 2017;91(5):1224–35. [DOI] [PubMed]
  • 86.Liao X, Shi K, Zhang Y, Huang X, Wang N, Zhang L et al. Contribution of CKD to mortality in middle-aged and elderly people with Diabetes: the China Health and Retirement Longitudinal Study. 2023;15(1):1–8. [DOI] [PMC free article] [PubMed]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Articles from Diabetology & Metabolic Syndrome are provided here courtesy of BMC

RESOURCES