The purpose of the research study is to describe the burden of disease among three different cohorts of patients: (1) patients diagnosed with CKD, (2) those with T2DM; and (3) those with T2DM and comorbid CKD.
Chronic kidney disease (CKD) has been ranked as the 10th leading cause of death in Canada as of 2013, while type 2 diabetes mellitus (T2DM) is one of the fastest growing diseases in Canada. There is a growing body of evidence that has examined these populations in real-world settings in Canada. The study described below will add to the growing body of literature that has examined CKD patients in Alberta and will contribute to an understanding of the epidemiology of CKD by stage, as well as healthcare resource utilization (HCRU) and costs. Furthermore, this study will contribute to a more nuanced understanding of the epidemiology, treatment patterns, HCRU and costs, and adverse events for T2DM patients with and without comorbid CKD in Alberta.
Study Type
OBSERVATIONAL
Enrollment
588,170
Not applicable - this is a non-interventional, observational study.
Incidence and prevalence
Incidence and prevalence of CKD (by stage), T2DM, and comorbid T2DM/CKD, including 1-, 4-, and 5-year period prevalence and incidence
Time frame: 2010 to 2018 fiscal years
Comorbidity and complication profiles and rates
For all three cohorts, comorbidities and complications of interest include: 1. Diabetic: hypoglycemia, lower limb amputations, diabetic ketoacidosis 2. Renal: acute kidney injury, acute renal failure, anemia, urogenital tract infections, albuminuria, hematuria, fast estimated glomerular filtration rate decline, CKD progression, continuous renal replacement therapy, dialysis initiation 3. Cardiovascular: CV events (atrial fibrillation, coronary artery disease, chronic heart failure, hypertension, myocardial infarction, hospitalization for heart failure (specific and broad), peripheral artery disease, stroke/transient ischemic attack (TIA)), CV hospitalization, CV mortality 4. Other: fractures and all-cause mortality 5. Any event: Composite outcome to capture any of the above For the CKD cohort, results will also be stratified by T2DM status. Comorbidity/complication rates between the T2DM and T2DM/CKD comorbid populations will be compared.
Time frame: 2010 to 2019 fiscal years
Factors that influence the progression of CKD in patients
Logistic regression model to assess association of variables of interest (age, sex, health region, comorbidities (Charlson Comorbidity Index as well as conditions in outcome 2), ACR, HbA1c, medication use. This will be performed for all patients with CKD and stratified by T2DM status.
Time frame: 2010 to 2019 fiscal years
Healthcare resource use (HCRU) and associated costs for CKD patients
HCRU include: inpatient hospitalizations, hospital length of stay, emergency department visits, general practitioner and specialist visits. Costs include: hospital costs, emergency department costs, physician costs, medication costs. This will be performed for all patients with CKD and stratified by T2DM status.
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Time frame: 2010 to 2019 fiscal years
Stage-to-stage progression of CKD across the follow-up years in patients with CKD
This will be performed for all patients with CKD and stratified by T2DM status.
Time frame: 2010 to 2019 fiscal years
Treatment patterns
1. Treatment patterns by year for all three cohorts 2. Drug treatment patterns in patients with T2DM and comorbid CKD versus current guidelines, 3. Treatment patterns for the CKD cohort will also be stratified by T2DM status.
Time frame: 2010 to 2019 fiscal years