The prevalence of chronic kidney disease and screening of renal function in type 2 diabetic patients in Finnish primary healthcare

• Published in: Primary Care Diabetes
• Main Authors: Hagnas M., Sundqvist H., Jokelainen J., Tumminia A., Vinciguerra F., Loreto C., Frittitta L., Russo G. T., Mikkola I.
• Other Authors: Hagnas, M., Sundqvist, H., Jokelainen, J., Tumminia, A., Vinciguerra, F., Loreto, C., Frittitta, L., Russo, G. T., Mikkola, I.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier Ltd 2020
• Subjects: Chronic kidney disease; Primary healthcare; Renal insufficiency; Screening; Type 2 diabetes; Rovaniemi
• Online Access: http://hdl.handle.net/11570/3204067; https://doi.org/10.1016/j.pcd.2020.05.005

Aims: To estimate the prevalence of chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) in Finnish primary healthcare, and to evaluate the screening for CKD and the proportions of patients receiving antihyperglycemic and cardiovascular preventive medication. Material and methods: T2D patients treated at the Rovaniemi Health Center, Finland during the years 2015–2019. Data included patient characteristics, blood pressure, HbA1c, lipid levels, kidney function and albuminuria, and medications prescribed. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.72 m2 and/or albuminuria. Results: The study population comprised of 5112 T2D patients with a mean (SD) age of 66.7 (13.0) years. Of these, 60.2% were screened for CKD with both eGFR and albuminuria, and 30.1% of these patients had CKD. The prevalence of moderately increased and severely increased albuminuria was 19.6% and 3.2%, respectively. A total of 57.0% of the study population received angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB). Conclusions: Screening for CKD with both recommended measures (eGFR and albuminuria) was insufficiently performed among this T2D population. Additionally, just over half of the study population had been prescribed ACE inhibitors or ARB. These results suggest an incongruity between the gold standard of diabetes care and real-world clinical practice.