Clinical characteristics and outcomes of patients with type 2 diabetes mellitus and chronic kidney disease from two new-user medication cohorts: a retrospective cohort study using regional electronic health records database in China.

Abstract

Given the rapidly evolving therapeutic landscape for type 2 diabetes (T2D) and chronic kidney disease (CKD), this study aimed to characterise the clinical profiles and real-world outcomes of patients with T2D and CKD in China who initiated sodium-glucose cotransporter 2 inhibitors (SGLT2i) or glucagon-like peptide-1 receptor agonists (GLP-1 RA). Retrospective cohort study. Demographic and clinical data of patients from a regional electronic health records database in Tianjin, China between 2012 and 2019 were used. Adult patients diagnosed with T2D and CKD who initiated SGLT2i or GLP-1 RA from 2012 to 2019. Baseline demographic and disease characteristics, comorbidities and comedications, healthcare resource utilisation (HRU), and clinical outcomes were assessed using descriptive statistics. A total of 935 and 4821 patients were included in SGLT2i and GLP-1 RA cohorts, with the mean ages of 59 and 56 years, respectively. Both cohorts had similar durations of T2D (mean: 5 years) and CKD (mean: 3 years). In SGLT2i and GLP-1 RA cohorts, 54.4% and 56.9% of patients had hemoglobin A1c (HbA1c) >7%, and 50.5% and 54.1% were classified as CKD stage 1 at baseline. During the follow-up period (median 1.4 months for SGLT2i cohort and median 2.3 months for GLP-1 RA cohort), higher numbers of specialist visits compared with general practitioner visits were observed numerically for both cohorts. The incidence rates (95% CI) of kidney failure per 100 person-years were 3.1 (1.0, 7.3) for SGLT2i cohort, and 4.9 (3.9, 6.0) for GLP-1 RA cohort during follow-up. This study provides descriptive evidence regarding the clinical characteristics and outcomes of patients with T2D and CKD who initiated SGLT2i or GLP-1 RA in China. The results are important for understanding the existing HRU and residual risk of severe clinical outcomes in such patient populations. The findings also provide a solid foundation for future research aimed at examining the clinical outcomes of new therapeutic options for T2D and CKD.