Clinical characteristics and the risk factors of patients with chronic kidney disease in young-onset versus late-onset newly diagnosed type 2 diabetes

Background The association between young-onset diabetes and chronic kidney disease has been well studied, however, few studies have described the features of chronic kidney disease (CKD) specifically in young-onset diabetes. We aimed to compare the clinical characteristics and risk factors for CKD between young-onset and late-onset newly diagnosed type 2 diabetes (T2DM). Methods In this retrospective study, 1194 newly diagnosed T2DM patients were categorized into young-onset (diagnostic age < 40 years) and late-onset (≥ 40 years) groups, further stratified by CKD status. Anthropometric and laboratory data were collected retrospectively. Clinical differences were analyzed using t-tests, Mann-Whitney U tests, and chi-square tests. Logistic regression was used to identify the risk factors for CKD. Results In newly diagnosed T2DM patients, CKD prevalence was similar between young-onset and late-onset groups (24.1% vs. 21.5%, p = 0.163), with no significant association between young-onset diabetes and CKD (OR: 1.16, 95%CI: 0.88–1.53, P = 0.292). Compared to CKD with late-onset diabetes, young-onset patients had higher urinary albumin-to-creatinine ratio, eGFR, BMI, diastolic blood pressure, lipid levels, fasting blood glucose, liver enzymes, and higher metabolic-associated steatotic liver disease prevalence. In both young and late onset groups, diastolic blood pressure and fasting blood glucose were independently associated with CKD, however, gamma-glutamyl transferase was independently associated with CKD only in the young-onset group. Conclusion Young-onset diabetes may not be an independent risk factor for CKD in newly diagnosed T2DM, but CKD patients with young-onset diabetes exhibit distinct clinical characteristics compared to those with late-onset diabetes. Elevated gamma-glutamyl transferase specifically predicted CKD in young-onset T2DM.