Prevalence and factors associated with rapid eGFR decline in type 2 diabetes mellitus patients with chronic kidney disease at Phayao Hospital
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Abstract
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a prevalent non-communicable disease worldwide, often leads to chronic kidney disease (CKD) as one of its most significant complications. A rapid decline in estimated glomerular filtration rate (eGFR) has been linked to multiple clinical and behavioral factors.
OBJECTIVE: This study aimed to determine the prevalence of T2DM with CKD patients and associated factors with rapid eGFR decline in T2DM with CKD patients at Phayao Hospital.
METHODS: A retrospective cohort study was conducted among 317 T2DM with CKD patients at Phayao Hospital. Clinical data were reviewed over a one-year period. Multivariate logistic regression analysis was performed to identify factors associated with a rapid decline in eGFR, defined as a decrease of ≥5 mL/min/1.73 m² per year.
RESULTS: The majority of participants with a rapid decline in eGFR were male (55.4%) with a mean age of 66.3 years. The prevalence of T2DM among participants with a rapid decline in eGFR was 82.3%. Systolic blood pressure was significantly associated with a rapid decline in eGFR (adjusted OR 1.02, 95% CI: 1.00–1.04, p=0.015).
CONCLUSIONS AND RECOMMENDATIONS: Rapid decline in kidney function is common among patients with T2DM and CKD. Elevated systolic blood pressure accelerates rapid decline of kidney function in T2DM with CKD patients, highlighting the need to prioritize effective blood pressure control to slow long-term deterioration of kidney function.
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References
International Diabetes Federation. IDF Diabetes Atlas 2025 [Internet]. Brussels: International Diabetes Federation; 2025 [cited 2025 Jun 28]. Available from: https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/
Department of Disease Control, Ministry of Public Health. Thailand diabetes report 2024 [Internet]. Nonthaburi: Department of Disease Control; 2024 [cited 2025 Jun 28]. Available from: https://www.ddc.moph.go.th/uploads/files/4155620240314033823.pdf
Thomas MC, Brownlee M, Susztak K, Sharma K, Jandeleit-Dahm KA, Zoungas S, et al. Diabetic kidney disease. Nat Rev Dis Primers. 2015;1:15018.
Coresh J, Turin TC, Matsushita K, Sang Y, Ballew SH, Appel LJ, et al. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality. JAMA. 2014;311(24):2518-31.
Xing J, Huang L, Ren W, Mei X. Risk factors for rapid kidney function decline in diabetes patients. Ren Fail. 2024;46(2):2398188.
Yamamoto R, Shinzawa M, Araki S, Yamamoto M, Fujii N, Kitazawa T, et al. Factors associated with rapid renal function decline in patients with diabetic kidney disease. Clin J Am Soc Nephrol. 2023;18(2):245-56.
Jitraknatee J, Ruengorn C, Nochaiwong S. Prevalence and risk factors of chronic kidney disease among type 2 diabetes patients: a cross-sectional study in primary care practice. Sci Rep. 2020;10(1):6205.
Jirawat S. Prevalence of chronic kidney disease and risk factors associated with reduced renal function among type 2 diabetic patients in Rong So urban health center, Phrae Province. J Phrae Hosp. 2019; 27(2): 1-15.
Furuichi K, Shimizu M, Yamanouchi M, Hoshino J, Sakai N, Iwata Y, et al. Clinicopathological features of fast eGFR decliners among patients with diabetic nephropathy. BMJ Open Diabetes Res Care. 2020;8(1):e001157.
Griffin TP, O'Shea PM, Smyth A, Islam MN, Wall D, Ferguson J, et al. Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe. BMJ Open Diabetes Res Care. 2021;9(1):e002125.
Theeranut A, Srina J, Sirivongs D, Adisuksodsai D, Rattanakanokchai S, Methakanjanasak N, Surit P. Factors associated with rapid decline of renal function in patients with kidney disease: a retrospective cohort study. J Nurs Sci Health. 2018;41(3):108-18.
Kittinuntaponchai K, Sukkha S. Current management of hypertension in chronic kidney disease. J Med Health Sci. 2021;28(2):149-64.
Vejakama P, Ingsathit A, Attia J, Thakkinstian A. Epidemiological study of chronic kidney disease progression: a large-scale population-based cohort study. Medicine (Baltimore). 2015;94(4):e475
Grams ME, Yang W, Rebholz CM, Wang X, Porter AC, Inker LA, et al. Risks of adverse events in advanced CKD: the chronic renal insufficiency cohort (CRIC) study. Am J Kidney Dis. 2017;70(3):337-46.
Utsumi K, Katsura K, Iino Y, Katayama Y. Blood pressure control in patients with chronic kidney disease. J Nippon Med Sch. 2012;79(2):111-4.
Boontakanon J. Factors associated with Rapid decline of Renal function in Patients with CKD stage 3-4 at Kasetsomboon Hospital, Chaiyaphum. Regional Health Promotion Center 9 Journal. 2023.17(1):14-27.
Poomsalood N, Satirapoj B. Long-term follow-up of decline glomerular filtration rate in type 2 diabetic patients. Royal Thai Army Medical Journal. 2016;69(4):159-66.
Boonpradab A, Pitsawong W. Prevalence and factors associated with chronic kidney disease in Phanomdongrak Chalermprakiet 80th Anniversary Hospital. Surin Province Surin Hosp Med Journal. 2019;34(2):205-16.
Nongwa T, Vonok L. Risk Factors for Progression from Stage 3 to Stage 4 Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus at Phimai Hospital, Nakhon Ratchasima Province: a retrospective cohort study. Regional Health Promotion Center 9 Journal. 2025;19(2):701-15.
