Long-term data from the Salford Care Record identified elevated blood pressure, smoking, and female sex as independent predictors of faster CKD progression in adults with type 2 diabetes mellitus (T2DM). The findings were presented at the 2025 European Association for the Study of Diabetes (EASD) Annual Meeting.

The 24-year prospective study analyzed 718 individuals with T2DM from 2001 to 2024. At baseline, 62.8% had normal kidney function, but by follow-up, 43% developed CKD and 1.4% progressed to end-stage kidney disease. Urine albumin-to-creatinine ratio (uACR) rose exponentially, while estimated glomerular filtration rate (eGFR) declined linearly by 1.02 mL/min/1.73m² per year.

Higher systolic and diastolic blood pressure predicted worsening uACR, particularly in participants with preserved eGFR. Among those without baseline CKD, faster eGFR decline correlated with female sex, smoking, elevated HbA1c, higher blood pressure, and lower cholesterol. Mortality increased sharply with CKD severity.

These findings underscore the importance of intensive blood pressure, glycemic, and lifestyle management to slow kidney function decline and improve long-term outcomes in T2DM.