A Study Using the LMC Diabetes Registry to Learn More About Chronic Kidney Disease (CKD) in Canadian Patients With Type 2 Diabetes (T2D)
- Conditions
- Chronic Kidney Disease in Type 2 Diabetes
- Interventions
- Drug: The physician's prescription in routine clinical practice
- Registration Number
- NCT04445181
- Lead Sponsor
- Bayer
- Brief Summary
In people with type 2 diabetes (T2D), the body does not make enough of a hormone called insulin or does not use insulin well. This results in high blood sugar levels.
People with T2D are at a higher risk of having a condition called chronic kidney disease (CKD). In people with CKD, the kidneys become damaged and do not work as they should. People with CKD can have trouble breathing and often have swelling in their arms and legs, and high blood pressure.
People who have CKD and T2D are more likely to have other medical problems, such as heart disease.
There are many treatments available to patients who have CKD and T2D. But, researchers need more information about how doctors in Canada are deciding which treatment to give these patients.
In this study, the researchers will review health information from men and women with T2D who visited a doctor in 2019 and had check-ups for at least 6 months. The health information will be taken from a Canadian registry (or database) owned by LMC Diabetes \& Endocrinology. The registry contains information from people that went to an LMC clinic. In this study, the researchers will learn how many of these people had T2D and CKD. They will learn the treatments these people received, and if they had other related medical problems. The researchers will also use surveys to ask the doctors about why they chose certain treatments.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 14873
- Clinical diagnosis of T2D as captured in the LMC EMR system
- Assessed by an LMC endocrinologist between January 1, 2019 and December 31, 2019
- Followed by an LMC endocrinologist for ≥ 6 months prior to inclusion in the cohort
- Informed consent to use patient medical record data for research purposes was provided
Among patients who meet the inclusion criteria, estimated glomerular filtration rate (eGFR) ≤ 60 ml/min/1.73 m^2 and/or urine albumin-to-creatinine ratio (uACR) ≥ 2 mg/mmol will be used to identify the cohort of patients with T2D and CKD
- Any patients with documented non-diabetic etiology for renal disease will be excluded from the numerator (number of patients with CKD and T2D) when determining the primary endpoint
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Patients with T2D The physician's prescription in routine clinical practice Active patients (defined as patients seen by an LMC endocrinologist between January 1, 2019 and December 31, 2019) with T2D (Type 2 Diabetes). Among the patients with T2D, those identified with CKD will be included in the renal registry.
- Primary Outcome Measures
Name Time Method Proportion of patients with CKD in a large T2D population Retrospectively analysis between January 1, 2019 and December 31, 2019 The data will be retrieved from the LMC Diabetes Registry, a Pan-Canadian registry of diabetes community-based specialist practices and used to develop a renal registry to investigate the primary objectives of the study
- Secondary Outcome Measures
Name Time Method Proportion of patients using the different therapies Retrospectively analysis between January 1, 2019 and December 31, 2019 The therapies are: ACEi, ARBs, ACEi/ARBs, MRAs, GLP-1 RA and SGLT2i
Proportion of patients with stage 1 CKD with moderate or greater albuminuria, stage 2 CKD with moderate or greater albuminuria, stage 3a CKD, stage 3b CKD, stage 4 CKD and stage 5 CKD in accordance with Canadian clinical practice guidelines Retrospectively analysis between January 1, 2019 and December 31, 2019 Stage 1 CKD: eGFR (estimated glomerular filtration rate) ≥ 90 ml/min/1.73 m\^2 Stage 2 CKD: eGFR between 60-89 ml/min/1.73 m\^2 Stage 3a CKD: eGFR between 45-59 ml/min/1.73 m\^2 Stage 3b CKD: eGFR between 30-44 ml/min/1.73 m\^2 Stage 4 CKD: eGFR between 15-29 ml/min/1.73 m\^2 Stage 5 CKD: eGFR \<15 ml/min/1.73 m\^2
Proportion of patients with microalbuminuria and macroalbuminuria, in accordance with Canadian clinical practice guidelines Retrospectively analysis between January 1, 2019 and December 31, 2019 Microalbuminuria: uACR (urine albumin-to-creatinine ratio) 2-20 mg/mmol Macroalbuminuria: uACR \> 20 mg/mmol
Proportion of patients within each albuminuria category (A1, A2 or A3), in accordance with KDIGO clinical practice guidelines Retrospectively analysis between January 1, 2019 and December 31, 2019 KDIGO = Kidney Disease: Improving Global Outcomes
Laboratory values for patients using either no therapy or using a therapy for ≥ 6 months Retrospectively analysis between January 1, 2019 and December 31, 2019 Laboratory values including glucose, glycated hemoglobin (HbA1c), lipids, creatinine, electrolytes, eGFR, and uACR
Proportion of patients with different comorbidities Retrospectively analysis between January 1, 2019 and December 31, 2019 Comorbidities like hypertension, dyslipidemia, microvascular disease, macrovascular disease
Proportion of healthcare provider prescriptions of RAS therapies (ACEi/ARB) used to treat hypertension, heart failure, coronary artery disease, CKD, or other condition On the day of healthcare provider completes a questionnaire RAS: renin angiotensin system ACEi: angiotensin converting enzyme inhibitors ARB: angiotensin receptor blocker
Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2DProportion of healthcare provider prescriptions of GLP-1 RA used to treat glycemia management, hypertension, heart failure, coronary artery disease, CKD or other condition On the day of healthcare provider completes a questionnaire GLP-1 RA: glucagon-like peptide-1 receptor agonist
Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2DProportion of healthcare provider prescriptions of MRAs used to treat hypertension, heart failure, coronary artery disease, CKD or other condition On the day of healthcare provider completes a questionnaire MRAs: mineralocorticoid receptor antagonists
Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2DProportion of healthcare provider prescriptions of SGLT2i used to treat glycemia management, hypertension, heart failure, coronary artery disease, CKD or other condition On the day of healthcare provider completes a questionnaire SGLT2i: sodium-glucose co-transporter-2 inhibitors
Healthcare providers will complete a questionnaire to determine their rationale for use of common therapies for CKD in T2D
Trial Locations
- Locations (1)
A Database
🇨🇦A Database, Canada