{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:17:45Z","timestamp":1790101065391,"version":"4.0.1"},"reference-count":17,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004326","name":"Bayer AG","doi-asserted-by":"crossref","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,2,7]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe prevalence of chronic kidney disease (CKD), demographic and clinical characteristics, treatment patterns and rates of cardiovascular and renal complications for patients with type 2 diabetes (T2D) treated in routine clinical care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Repeat cross-sectional study (6 monthly cross-sections) and cohort study from 1 January 2017 to 31 December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care data from English practices contributing to the UK Clinical Practice Research Datalink linked to Hospital Episode Statistics and Office for National Statistics mortality data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with T2D aged &gt;18 years, at least one year of registration data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>\n                      Primary outcome was prevalence of CKD defined as chronic kidney disease epidemiology collaboration (CKD-EPI) estimated glomerular filtration rate &lt;60\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      , and\/or urinary albumin creatinine ratio \u22653\u2009mg\/mmol in the past 24 months. Secondary outcomes were prescriptions of medications of interest and clinical and demographic characteristics in the past 3 months.\n                    <\/jats:p>\n                    <jats:p>In the cohort study rates of renal and cardiovascular complications, all-cause mortality and hospitalisations over the study period were compared among those with and without CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 574\u2009190 eligible patients with T2D as of 1 January 2017 and 664\u2009296 as of 31 December 2019. Estimated prevalence of CKD across the study period was stable at approximately 30%. Medication use was stable over time in people with CKD and T2D, with low use of steroidal mineralocorticoid receptor antagonists (approximately 4.5% across all time points) and a low use but steady increase in use of sodium-glucose co-transporter-2 inhibitors (from 2.6% to 6.2%). Rates of all complications were higher in those with CKD at the start of the study period, with increasing rates, with increased severity of CKD, heart failure and albuminuria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The burden of CKD in patients with T2D is high and associated with substantially increased rates of complications particularly in those with comorbid heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-065927","type":"journal-article","created":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T08:48:24Z","timestamp":1678178904000},"page":"e065927","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Characterising the burden of chronic kidney disease among people with type 2 diabetes in England: a cohort study using the Clinical Practice Research Datalink"],"prefix":"10.1136","volume":"13","author":[{"given":"Sarah","family":"Cook","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Schmedt","sequence":"additional","affiliation":[{"name":"Bayer AG, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Broughton","sequence":"additional","affiliation":[{"name":"Bayer plc, Reading, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A","family":"Kalra","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, University of Manchester, Manchester, UK"},{"name":"Department of Renal Medicine, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8848-9493","authenticated-orcid":false,"given":"Laurie A","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-4869","authenticated-orcid":false,"given":"Jennifer K","family":"Quint","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"2025120521122680000_13.3.e065927.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310799"},{"key":"2025120521122680000_13.3.e065927.2","first-page":"49","article-title":"Diabetic kidney disease: world wide difference of prevalence and risk factors","volume":"5","author":"Gheith","year":"2016","journal-title":"J Nephropharmacol"},{"key":"2025120521122680000_13.3.e065927.3","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-1296"},{"key":"2025120521122680000_13.3.e065927.4","unstructured":"National KF . KIDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements, 2013: 3."},{"key":"2025120521122680000_13.3.e065927.5","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006101159"},{"key":"2025120521122680000_13.3.e065927.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60595-4"},{"key":"2025120521122680000_13.3.e065927.7","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1053\/j.ajkd.2018.06.017","article-title":"Incident type 2 diabetes among individuals with CKD: findings from the chronic renal insufficiency cohort (CRIC) study","volume":"73","author":"Jepson","year":"2019","journal-title":"Am J Kidney Dis"},{"key":"2025120521122680000_13.3.e065927.8","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X714125"},{"key":"2025120521122680000_13.3.e065927.9","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-015-0189-z"},{"key":"2025120521122680000_13.3.e065927.10","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5000058"},{"key":"2025120521122680000_13.3.e065927.11","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012070718"},{"key":"2025120521122680000_13.3.e065927.12","doi-asserted-by":"publisher","DOI":"10.2337\/db08-1543"},{"key":"2025120521122680000_13.3.e065927.13","unstructured":"Department oH . Turning the corner: improving diabetes care. 2006. Available: https:\/\/webarchive.nationalarchives.gov.uk\/ukgwa\/20130123210127\/http:\/\/www.dh.gov.uk\/en\/Publicationsandstatistics\/Publications\/PublicationsPolicyAndGuidance\/DH_4136141"},{"key":"2025120521122680000_13.3.e065927.14","doi-asserted-by":"crossref","first-page":"1740g","DOI":"10.1093\/ije\/dyz034","article-title":"Data resource profile: clinical practice research datalink (CPRD) aurum","volume":"48","author":"Wolf","year":"2019","journal-title":"Int J Epidemiol"},{"key":"2025120521122680000_13.3.e065927.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60674-5"},{"key":"2025120521122680000_13.3.e065927.16","unstructured":"Nitsch D , Caplin B , Hull S , et al . National chronic kidney disease audit\/\/national report (part 1) january 2017. 2017. Available: https:\/\/www.lshtm.ac.uk\/files\/ckd_audit_report.pdf"},{"key":"2025120521122680000_13.3.e065927.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2025845"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-065927","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:12:36Z","timestamp":1764997956000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-065927"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,7]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/bmjopen-2022-065927"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-065927","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}