Albuminuria is widely used to assess kidney disease progression in patients with type 2 diabetes mellitus (T2DM), but its association with retinal and neurologic complications in individuals with chronic kidney disease (CKD) has remained less clearly defined. A Danish registry-based analysis published in Diabetes Research and Clinical Practice evaluated whether increasing urine albumin-creatinine ratio (UACR) levels are associated with higher prevalence and incidence of microvascular complications in adults with T2DM and CKD.
The analysis included 27,924 adults with T2DM and established CKD identified through Danish healthcare registries between 2010 and 2023. CKD was defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m². Outcomes included diabetic retinopathy, polyneuropathy, and CKD progression. Logistic regression models evaluated baseline prevalence, while Cox regression analyses estimated standardized 5-year risks across UACR categories.
Findings
- Median age was 75 years (IQR 69-80), 41.5% of participants were women, and median eGFR was 53 mL/min/1.73 m² (IQR 47-56).
- Odds ratios for diabetic retinopathy and polyneuropathy increased with higher UACR levels at baseline.
- Standardized 5-year risks of diabetic retinopathy, polyneuropathy, and CKD progression increased progressively across UACR strata.
- Higher UACR levels were consistently associated with greater microvascular disease burden in adults with T2DM and CKD.
Increasing albuminuria levels were associated with higher prevalence and incidence of retinal, neurologic, and kidney complications in adults with T2DM and CKD.
