Risk factors for nephropathy in individuals with new-onset type 2 diabetes undergoing treatment for hypertension: A retrospective analysis using the Diagnosis Procedure Combination database

• Published in: Annals of Clinical Epidemiology Vol. 7; no. 3; pp. 71 - 79
• Main Authors: Ishigaki Suzuki, Tomoko, Saito Oba, Mari, Uemura, Kohei
• Format: Journal Article
• Language: English
• Published: Japan Society for Clinical Epidemiology 01.07.2025; 一般社団法人 日本臨床疫学会
• Subjects: hypertension treatment; new type 2 diabetes; Onset of diabetic nephropathy; Original; risk factor; hypertension treatment; Onset of diabetic nephropathy; new type 2 diabetes; risk factor
• ISSN: 2434-4338; 2434-4338
• DOI: 10.37737/ace.25009

BACKGROUNDDiabetic nephropathy is a common complication of diabetes. We investigated the risk factors for diabetic nephropathy in individuals newly diagnosed with type 2 diabetes.METHODSData from the Japanese Diagnosis Procedure Combination in-patient database (April 2008 to December 2018) were analyzed. The endpoint was subsequent diabetic nephropathy diagnosis or as the time when estimated glomerular filtration rate become <60 ml/min/1.73 m2. Candidate risk factors included age, Hemoglobin A1c, log-transformed triglyceride, total cholesterol, and high-density lipoprotein cholesterol levels, body mass index, and estimated glomerular filtration rate. Eligible individuals with type 2 diabetes without complications who had pre- and post-diagnosis Hemoglobin A1c and serum creatinine measurements, and a history of hypertension or cardiovascular disease pre-diagnosis. Those with pre-existing kidney diseases, nephropathy onset pre-diagnosis, estimated glomerular filtration rate <60 ml/min/1.73 m2 on or before diabetes diagnosis, or age <20 years at diabetes diagnosis were excluded. A multivariate Cox proportional hazards model (p = 0.2 backward selection) was employed.RESULTSOf 2,664 eligible individuals (1,775 men, 889 women), 325 men and 175 women developed diabetic nephropathy during follow-up. Cumulative incidence within 5 years was 29.0% in men and 32.5% in women. Age and estimated glomerular filtration rate in both sexes, and total cholesterol in men were significant.CONCLUSIONSAge, estimated glomerular filtration rate, and lipid pose potential risks for diabetic nephropathy onset within 5 years of diabetes diagnosis in individuals with hypertension. Collectively, our findings highlight the importance of early monitoring and intervention in this high-risk.