Factors Associated with Chronic Kidney Disease Risk Categories According to KDIGO Criteria among Patients with Type 2 Diabetes Mellitus in Thailand: A Secondary Data Analysis Using Ordinal Logistic Regression
DOI:
https://doi.org/10.64767/trcn.2026.281456Keywords:
chronic kidney disease, type 2 diabetes mellitus, KDIGO, ordinal logistic regressionAbstract
Introduction: Chronic kidney disease (CKD) is a major complication in patients with type 2 diabetes mellitus (T2DM), increasing the risk of kidney failure and mortality.
Objectives: This study aimed to identify factors associated with KDIGO CKD risk categories among patients with T2DM in Thailand
Method: This analytical study used secondary data from the Thailand DM/HT 2018 database. Data from 7,824 patients aged at least 20 years with complete information on eGFR, UACR, and study covariates were analyzed using descriptive statistics and ordinal logistic regression. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were reported to estimate the odds of being in a higher versus lower KDIGO risk category.
Result: Participants were classified as having low, moderate, high, and very high CKD risk at 40.1%, 34.4%, 13.5%, and 11.9%, respectively. After adjustment, higher risk categories were associated with older age (aOR = 1.032; 1.027-1.036), longer diabetes duration (aOR = 1.015; 95% CI = 1.006-1.024), higher HbA1c (aOR = 1.052; 1.028-1.077), and higher systolic blood pressure (aOR = 1.008; 1.005-1.011). Higher odds were also observed among patients with diabetic retinopathy (aOR = 1.788; 1.504-2.125), gout (aOR = 1.693; 1.399-2.049), and cardiovascular disease (aOR = 1.209; 1.022-1.431). Compared with no glucose-lowering medication, insulin alone (aOR = 4.563; 3.420-6.089) and sulfonylurea alone (aOR = 1.951; 1.484-2.565) showed the strongest associations. Because prescribing medication is influenced by clinical indications, these associations should not be interpreted causally.
Conclusion: Age, diabetes duration, glycemic control, systolic blood pressure, diabetic complications, comorbidities, and glucose-lowering medication use were associated with higher KDIGO CKD risk categories among patients with T2DM. Systematic assessment using eGFR and UACR may support risk-based screening, prioritization, and individualized care planning.
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