Patient Characteristics and Outcomes of Hospitalized Chronic Kidney Disease Patients with and without Type 2 Diabetes Mellitus: Observations from the German Claims Data-Based Cohort of the CaReMe-CKD Multinational Study

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2024-07-22 DOI:10.2147/clep.s459767

Johannes Leiner, Vincent Pellissier, Sebastian König, Lars Stellmacher, Sven Hohenstein, Carolin Schanner, Stefan Kwast, Ralf Kuhlen, Andreas Bollmann

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引用次数: 0

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is a leading cause of chronic kidney disease (CKD) globally. Both conditions substantially worsen patients’ prognosis. Current data on German in-hospital CKD cohorts are scarce. The multinational CaReMe study was initiated to evaluate the current epidemiology and healthcare burden of cardiovascular, renal and metabolic diseases. In this substudy, we share real-world data on CKD inpatients stratified for coexisting T2DM derived from a large German hospital network.
Methods: This study used administrative data of inpatient cases from 89 Helios hospitals from 01/01/2016 to 28/02/2022. Data were extracted from ICD-10-encoded discharge diagnoses and OPS-encoded procedures. The first case meeting a previously developed CKD definition (defined by ICD-10- and OPS-codes) was considered the index case for a particular patient. Subsequent hospitalizations were analysed for readmission statistics. Patient characteristics and pre-defined endpoints were stratified for T2DM at index case.
Results: In total, 48,011 patients with CKD were included in the present analysis (mean age ± standard deviation, 73.8 ± 13.1 years; female, 44%) of whom 47.9% had co-existing T2DM. Patients with T2DM were older (75 ± 10.6 vs 72.7 ± 14.9 years, p < 0.001), but gender distribution was similar to patients without T2DM. The burden of cardiovascular disease was increased in patients with T2DM, and index and follow-up in-hospital mortality rates were higher. Non-T2DM patients were characterised by more advanced CKD at baseline. Patients with T2DM had consistently higher readmission numbers for all events of interest, except for readmissions due to kidney failure/dialysis, which were more common in non-T2DM patients.
Conclusion: In this study, we present recent data on hospitalized patients with CKD in Germany. In this CKD cohort, nearly half had T2DM, which substantially affected cardiovascular disease burden, rehospitalization frequency and mortality. Interestingly, non-diabetic patients had more advanced underlying renal disease, which affected renal outcomes.

Keywords: chronic kidney disease, type 2 diabetes mellitus, administrative data, in-hospital mortality, kidney failure, rehospitalization

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患有和未患有 2 型糖尿病的住院慢性肾病患者的患者特征和疗效：基于德国索赔数据的 CaReMe-CKD 跨国研究队列观察结果

导言：2 型糖尿病（T2DM）是全球慢性肾脏病（CKD）的主要病因。这两种疾病都会严重恶化患者的预后。目前有关德国院内 CKD 队列的数据很少。跨国 CaReMe 研究旨在评估当前心血管、肾脏和代谢性疾病的流行病学和医疗负担。在这项子研究中，我们分享了来自德国一家大型医院网络的 CKD 住院病人的真实数据，这些数据根据并存的 T2DM 进行了分层：本研究使用了89家Helios医院从2016年1月1日至2022年2月28日的住院病例管理数据。数据提取自ICD-10编码的出院诊断和OPS编码的手术。符合先前制定的 CKD 定义（由 ICD-10 和 OPS 编码定义）的首个病例被视为特定患者的索引病例。随后的住院病例将进行再入院统计分析。根据指标病例中的 T2DM 对患者特征和预设终点进行分层：本分析共纳入 48 011 名慢性肾脏病患者（平均年龄为 73.8 ± 13.1 岁；女性占 44%），其中 47.9% 的患者同时患有 T2DM。患有 T2DM 的患者年龄较大（75 ± 10.6 岁 vs 72.7 ± 14.9 岁，p < 0.001），但性别分布与未患有 T2DM 的患者相似。T2DM患者的心血管疾病负担加重，指数和随访院内死亡率较高。非T2DM患者基线时的慢性肾功能衰竭程度更高。除了肾衰竭/透析导致的再入院在非T2DM患者中更为常见外，T2DM患者在所有相关事件中的再入院率一直较高：在这项研究中，我们提供了德国慢性肾脏病住院患者的最新数据。在这组慢性肾脏病患者中，近半数患有 T2DM，这严重影响了心血管疾病负担、再住院频率和死亡率。有趣的是，非糖尿病患者的潜在肾脏疾病更为严重，这也影响了肾脏疾病的治疗效果。关键词：慢性肾脏病、2 型糖尿病、管理数据、院内死亡率、肾衰竭、再住院率

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.