Risk factors associated with Indian type 2 diabetes patients with chronic kidney disease: CITE study, a cross-sectional, real-world, observational study.

BACKGROUND

Type 2 diabetes (T2DM) is the leading cause of chronic kidney disease (CKD) worldwide. Identifying clinical and laboratory associations with chronic kidney disease (CKD) in type 2 diabetes (T2DM) can help physicians target modifiable risk factors. In light of limited data from India, the CITE (CKD in Indian T2DM Evaluation) study was conducted.

METHODS

The multicenter, cross-sectional CITE study included 3,325 patients from 28 centres across India over a three-month period. CKD was defined as a persistent decline in kidney function (eGFR < 60 ml/min/1.73 m² for ≥ 3 months) or an elevated urine albumin-to-creatinine ratio (UACR) in at least two samples. Descriptive statistics summarised patient characteristics, while logistic regression analyses identified significant risk factors for CKD.

RESULTS

The prevalence of CKD in T2DM was 32%, with a median patient age of 59.9 years and 60.72% having a T2DM duration > 10 years. Reduced eGFR (< 60 ml/min/1.73 m²) was associated with older age (OR: 2.47, 95% CI 2.11-2.88, P < 0.001), longer T2DM duration (OR: 2.28, 95% CI 1.77-2.93, P < 0.001), higher HbA1c (OR: 1.039, 95% CI 1.001-1.079, P = 0.046), and elevated SBP (OR: 1.005, 95% CI 1.002-1.009, P = 0.003). Macroalbuminuria (UACR > 300 mg/g) was linked to non-vegetarian diet (OR: 1.95, 95% CI: 1.59-2.40, P < 0.001) and tobacco use (OR: 1.42, 95% CI: 1.17-1.73, P < 0.001). CKD increased comorbidity odds.

CONCLUSION

The CITE study highlights the prevalence of CKD (32%) in Indian patients with T2DM and identifies clinical and laboratory factors associated with CKD, including age ≥ 60 years, T2DM duration, SBP, HbA1c, tobacco use, non-vegetarian diet, and comorbidities. Longitudinal studies are needed to confirm these associations and evaluate causality.