Chronic kidney disease progression is a major determinant of morbidity and mortality in type 2 diabetes. Data presented at the European Association for the Study of Diabetes Congress 2025 analyzed 24 years of longitudinal patient records from the Salford Care Record, including 718 individuals. Urine albumin-to-creatinine ratio and estimated glomerular filtration rate were monitored to identify factors influencing kidney function decline.

At baseline, 62.8% of participants had normal kidney function; after 24 years, 43% of these developed chronic kidney disease, and 1.4% progressed to end-stage kidney disease. Albuminuria increased exponentially over time, with systolic and diastolic blood pressure as the strongest predictors, especially in patients with preserved filtration at baseline. Decline in filtration rate was linear, with female sex, higher blood pressure, higher glycated hemoglobin, smoking, and lower baseline cholesterol independently associated with faster eGFR loss. Mortality at 24 years was highest among participants with baseline chronic kidney disease and elevated albuminuria.

These findings highlight the multifactorial nature of kidney disease progression and underscore the importance of early risk factor management to slow decline and reduce mortality in type 2 diabetes.