Risk factors associated with Indian Type 2 diabetes patients with chronic kidney disease: CITE study, A Cross-sectional, Real-world, Observational Study

Background: Type 2 diabetes (T2D) is the leading cause of chronic kidney disease (CKD) worldwide. Identifying clinical and laboratory associations with CKD in T2D can assist physicians in targeting modifiable risk factors. In light of limited data from India, the CITE (CKD in Indian T2D Evaluation) study was conducted. Methods: The multicenter, cross-sectional CITE study included 3,325 patients from 28 centres across India over three months. CKD was defined as a persistent decline in kidney function (eGFR < 60 ml/min for ≥ 3 months) or an elevated urine albumin-creatinine ratio (UACR) in at least two samples. Descriptive statistics summarised patient characteristics, while logistic regression analyses identified significant risk factors for CKD. Results: The prevalence of CKD in T2D was 34%, with a median patient age of 59.9 years and 60.72% having a T2D duration of more than 10 years. Reduced eGFR (< 60 ml/min) was significantly associated with age ≥ 60 years (OR: 2.46, 95% CI 2.11–2.87, P < 0.001), T2D duration of more than 10 years (OR: 2.27, 95% CI 1.76–2.92, P < 0.001), HbA1c (OR: 1.04, 95% CI 1.00–1.08, P = 0.03), and SBP (OR: 1.005, 95% CI 1.002–1.009, P < 0.001). Macroalbuminuria (UACR > 300 mg/g) was linked to a non-vegetarian diet (OR: 1.95, 95% CI 1.59–2.39, P < 0.001) and tobacco use (OR: 1.38, 95% CI 1.14–1.65, P = 0.001). CKD also increased the odds of comorbidities. Conclusion: The CITE study highlights the prevalence and risk factors of CKD in Indian T2D patients. Longitudinal studies are needed to evaluate these associations further.