Evaluating chronic kidney disease in Spanish people with diabetes: a study from internal medicine clinics

Abstract

Aim: To determine the prevalence and characteristics of chronic kidney disease (CKD) in a cross-sectional population of people with type 2 diabetes treated at internal medicine clinics in Spain.

Methods: We collected data from 25 hospitals that recruited 354 people with type 2 diabetes in an observational study carried out in May 2024. Information collected included demographic data, comorbidities, nutritional status, presence of sarcopenia and frailty, as well as laboratory data and therapy administered.

Results: We included a total of 314 subjects, of whom 185 (58.9%; 95% confidence interval: 53.4-64.3%) had CKD. Compared with people with no CKD, those with CKD were older (77.4 ± 9.7 vs. 65.9 ± 12.5 years; p < 0.001), more often male (53.1% vs. 46.9%; p = 0.021), with more prevalence of ischemic heart disease (22.4% vs. 10.9%; p = 0.006) and longer duration of diabetes disease (14.1 ± 8.6 vs. 10.0 ± 7.0 years; p < 0.001). Malnutrition (37.3% vs. 25%; p = 0.017), sarcopenia (24.6% vs. 11.2%; p = 0.003), and frailty (74.3% vs. 59%; p = 0.006) were more often associated in people with CKD compared with those without CKD.

Conclusion: Internal medicine specialists treat a significant number of people with diabetes and CKD. These people are characteristically elderly, with high proportion of cardiovascular disease showing malnutrition, sarcopenia, and frailty, which could determine the target for metabolic control.

Keywords: Ambulatory care; Chronic kidney disease; Cuidado ambulatorio; Diabetes mellitus; Enfermedad renal crónica; Internal medicine; Medicina interna; Patrones de práctica; Practice patterns.