{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:11Z","timestamp":1787014091724,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) is a serious and common complication of type 1 diabetes (T1D). Despite improvements in diabetes management, the prevalence of CKD in people with T1D remains high. However, large\u2010scale, real\u2010world data from the UK are limited. This study aimed to provide contemporary estimates of CKD incidence and its associated risk factors in a population with T1D in Salford, Greater Manchester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using anonymised electronic health records from the Salford Integrated Record Research Database between 2010 and 2023. Adults with T1D were assessed for CKD, defined as an estimated glomerular filtration rate (eGFR) &lt;60\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      and\/or albuminuria (urine albumin\u2010to\u2010creatinine ratio \u22653\u2009mg\/mmol), confirmed by two readings at least 90\u2009days apart. Competing risk regression models (accounting for death as a competing event) were used to identify associations with demographic and clinical risk factors, including age, sex, ethnicity, deprivation, smoking, body mass index (BMI), HbA1c and use of ACE inhibitors or ARBs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1106 adults with T1D, 38.5% developed reduced eGFR, 47.2% had albuminuria, and 23.8% met both criteria for CKD. Older age was strongly associated with reduced eGFR: compared to those aged 18\u201328\u2009years, the sub\u2010distribution hazard ratio (sHR) was 3.1 (95% CI: 2.0\u20135.0) for ages 42\u201354 and 8.6 (95% CI: 5.4\u201313.9) for \u226555\u2009years. Other significant predictors included missing ethnicity data (sHR 1.5), higher BMI (sHR 1.1 per kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), higher HbA1c (sHR 1.1 per mmol\/mol) and not being prescribed an ACE inhibitor or ARB (sHR 1.4).\n                    <\/jats:p>\n                    <jats:p>For albuminuria, increased risk was associated with female sex (sHR 1.3), missing ethnicity (sHR 1.4), higher HbA1c (sHR 1.1), current smoking (sHR 1.5), living in the second most deprived quintile (sHR 1.9) and being prescribed ACE inhibitors or ARBs (sHR 2.1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This large UK cohort study highlights a high burden of CKD among adults with T1D. Key risk factors included older age, higher BMI, poor glycaemic control, smoking and deprivation. Although ACE inhibitors and ARBs were commonly prescribed, the uptake of newer reno\u2010protective treatments was low. These findings point to a need for earlier detection, targeted interventions and broader implementation of effective therapies to reduce kidney disease burden in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70175","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:06:49Z","timestamp":1763705209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence and risk factors for chronic kidney disease in individuals with type 1 diabetes: A population\u2010based study in Salford, Manchester"],"prefix":"10.1111","volume":"43","author":[{"given":"Hellena Hailu","family":"Habte\u2010Asres","sequence":"first","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London  London UK"},{"name":"Royal Free London NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Stedman","sequence":"additional","affiliation":[{"name":"Res Consortium  Andover UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-755X","authenticated-orcid":false,"given":"Angus","family":"Forbes","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2617-8320","authenticated-orcid":false,"given":"Janaka","family":"Karalliedde","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine &amp; Sciences, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0745-3478","authenticated-orcid":false,"given":"David C.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"UCL Department of Nephrology, University College London, Royal Free Campus  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9537-4050","authenticated-orcid":false,"given":"Adrian H.","family":"Heald","sequence":"additional","affiliation":[{"name":"The School of Medicine and Manchester Academic Health Sciences Centre, Manchester University  Manchester UK"},{"name":"Diabetes and Endocrinology, Salford Royal Hospital  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06197-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00168-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00099-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-0335"},{"key":"e_1_2_10_6_1","article-title":"Prevalence and severity of chronic kidney disease in a population with type 1 diabetes from a United States health system: a real\u2010world cohort study","volume":"47","author":"Tuttle KR","year":"2025","journal-title":"Lancet Reg Health \u2013 Am"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.110117"},{"key":"e_1_2_10_8_1","volume-title":"Clinical practice guidline for diabetes management in chronic kidney disease","author":"KDIGO","year":"2022"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-2839"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.11.026"},{"issue":"12","key":"e_1_2_10_11_1","article-title":"The prevalence of chronic kidney disease and albuminuria in patients with type 1 and type 2 diabetes attending a single Centre","volume":"14","author":"Majeed MS","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2024.01.009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2500173"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000540"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-0815"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03317-8"},{"key":"e_1_2_10_17_1","volume-title":"Time to act: a new review of kidney health inequalities","author":"Sharma S","year":"2024"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2207018"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2024.09.004"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15381"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15260"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70175","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.70175","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:34:12Z","timestamp":1773012852000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.70175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/dme.70175"],"URL":"https:\/\/doi.org\/10.1111\/dme.70175","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"assertion":[{"value":"2025-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70175"}}