Epidemiología, características y gestión de la enfermedad renal crónica asociada a la diabetes en un área sanitaria de Cádiz

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN Pub Date : 2025-09-18 DOI:10.1016/j.semerg.2025.102584

J. Escribano-Serrano , E. Jiménez-Varo , M. Escribano-Cobalea , C. Casto-Jarillo , A. López-Ceres , E. Campos-Dávila , A. Hormigo-Pozo , C. Nieto-Ordoñez , M.Á. Rodríguez-Juliá , A. Michán-Doña

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Abstract

Introduction

Chronic Kidney Disease associated with Diabetes Mellitus (CKD-DM) is a prevalent condition with significant morbidity, mortality, and healthcare burden. Despite its relevance, its specific characteristics within the Spanish context have been scarcely described.

Objective

To determine the prevalence, clinical phenotypes, and therapeutic management of CKD-DM according to KDIGO guidelines in a healthcare area in southern Spain.

Methods

Observational, cross-sectional, and retrospective study based on SIDICAM records from July 2021 to June 2023 in the Campo de Gibraltar East Health Management Area. Diabetic patients (PDM) were identified and classified according to KDIGO 2024 criteria: estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR).

Results

Among the 8,732 PDM analyzed, 32.3% had CKD-DM (95% CI: 31.3%-33.2%), and 6.9% met criteria for nephrology-range CKD-DM. The predominant phenotype was eGFR < 60 mL/min/1.73 m² (14.2%), followed by the combined phenotype (9.2%) and isolated albuminuria (8.9%). Prevalence was higher in women and increased with age and diabetes duration. SGLT2 inhibitors were used in 48% of patients with CKD-DM, rising to 60% among the youngest group.

Conclusion

CKD-DM shows a high prevalence and phenotypic variability according to age, sex, and diabetes progression. This study highlights the need for personalized preventive and therapeutic strategies, as well as the crucial role that primary care must play in the early detection and management of CKD-DM.

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[在健康地区与糖尿病相关的慢性肾脏疾病的流行病学、特征和管理Cádiz]。

慢性肾脏疾病合并糖尿病（CKD-DM）是一种具有显著发病率、死亡率和医疗负担的常见病。尽管它具有相关性，但它在西班牙背景下的具体特点却很少得到描述。目的：根据西班牙南部某医疗保健地区的KDIGO指南，确定CKD-DM的患病率、临床表型和治疗管理。方法：基于2021年7月至2023年6月在Campo de Gibraltar East卫生管理区的SIDICAM记录进行观察性、横断面和回顾性研究。糖尿病患者（PDM）根据KDIGO 2024标准进行识别和分类：估计肾小球滤过率（eGFR）和白蛋白与肌酐比（ACR）。结果：在分析的8732例PDM中，32.3%患有CKD-DM (95% CI: 31.3%-33.2%)， 6.9%符合肾脏学范围的CKD-DM标准。主要表型为eGFR 2(14.2%)，其次为联合表型（9.2%）和分离性蛋白尿（8.9%）。女性患病率较高，且随年龄和糖尿病病程增加而增加。48%的CKD-DM患者使用SGLT2抑制剂，在最年轻的一组中上升到60%。结论：CKD-DM根据年龄、性别和糖尿病进展表现出较高的患病率和表型变异性。这项研究强调了个性化预防和治疗策略的必要性，以及初级保健在CKD-DM的早期发现和管理中必须发挥的关键作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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