Chronic Kidney Diseases, Type 2 Diabetes
Conditions
Brief summary
The purpose of the research study is to describe the burden of disease among three different cohorts of patients: (1) patients diagnosed with CKD, (2) those with T2DM; and (3) those with T2DM and comorbid CKD.
Detailed description
Chronic kidney disease (CKD) has been ranked as the 10th leading cause of death in Canada as of 2013, while type 2 diabetes mellitus (T2DM) is one of the fastest growing diseases in Canada. There is a growing body of evidence that has examined these populations in real-world settings in Canada. The study described below will add to the growing body of literature that has examined CKD patients in Alberta and will contribute to an understanding of the epidemiology of CKD by stage, as well as healthcare resource utilization (HCRU) and costs. Furthermore, this study will contribute to a more nuanced understanding of the epidemiology, treatment patterns, HCRU and costs, and adverse events for T2DM patients with and without comorbid CKD in Alberta.
Interventions
OTHERNot applicable - this is a non-interventional, observational study.
Not applicable - this is a non-interventional, observational study.
Sponsors
Medlior Health Outcomes Research Ltd
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(either of the following): * Chronic kidney disease identified using laboratory test and health administrative data * Type 2 diabetes mellitus identified using health administrative data
Exclusion criteria
* Age \< 18 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence and prevalence | 2010 to 2018 fiscal years | Incidence and prevalence of CKD (by stage), T2DM, and comorbid T2DM/CKD, including 1-, 4-, and 5-year period prevalence and incidence |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comorbidity and complication profiles and rates | 2010 to 2019 fiscal years | For all three cohorts, comorbidities and complications of interest include: 1. Diabetic: hypoglycemia, lower limb amputations, diabetic ketoacidosis 2. Renal: acute kidney injury, acute renal failure, anemia, urogenital tract infections, albuminuria, hematuria, fast estimated glomerular filtration rate decline, CKD progression, continuous renal replacement therapy, dialysis initiation 3. Cardiovascular: CV events (atrial fibrillation, coronary artery disease, chronic heart failure, hypertension, myocardial infarction, hospitalization for heart failure (specific and broad), peripheral artery disease, stroke/transient ischemic attack (TIA)), CV hospitalization, CV mortality 4. Other: fractures and all-cause mortality 5. Any event: Composite outcome to capture any of the above For the CKD cohort, results will also be stratified by T2DM status. Comorbidity/complication rates between the T2DM and T2DM/CKD comorbid populations will be compared. |
| Factors that influence the progression of CKD in patients | 2010 to 2019 fiscal years | Logistic regression model to assess association of variables of interest (age, sex, health region, comorbidities (Charlson Comorbidity Index as well as conditions in outcome 2), ACR, HbA1c, medication use. This will be performed for all patients with CKD and stratified by T2DM status. |
| Healthcare resource use (HCRU) and associated costs for CKD patients | 2010 to 2019 fiscal years | HCRU include: inpatient hospitalizations, hospital length of stay, emergency department visits, general practitioner and specialist visits. Costs include: hospital costs, emergency department costs, physician costs, medication costs. This will be performed for all patients with CKD and stratified by T2DM status. |
| Stage-to-stage progression of CKD across the follow-up years in patients with CKD | 2010 to 2019 fiscal years | This will be performed for all patients with CKD and stratified by T2DM status. |
| Treatment patterns | 2010 to 2019 fiscal years | 1. Treatment patterns by year for all three cohorts 2. Drug treatment patterns in patients with T2DM and comorbid CKD versus current guidelines, 3. Treatment patterns for the CKD cohort will also be stratified by T2DM status. |
Outcome results
None listed