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논문분류	춘계학술대회 초록집
제목	Comparative Cardiovascular and Renal Outcomes in Diabetic Versus Non-Diabetic Metabolic Kidney Disease: A Multicentric Nationwide Database Analysis
저자	Sajjad Ahmed Khan
출판정보	2026; 2026(1):
키워드	Diabetic metabolic kidney disease, Non-diabetic metabolic kidney disease, Cardiovascular outcomes, Renal outcomes
초록	Objectives: To assess and compare the incidence of major cardiovascular events, heart failure, arrhythmias, renal replacement therapy dependence, and mortality in patients with Diabetic Kidney Disease (DKD) versus Non-Diabetic Metabolic Kidney Disease (NDMKD). Methods: The TriNetX global health research network, including 113 healthcare organizations, was used to conduct this nationwide cohort study. Adult patients (≥18 years) with CKD and metabolic comorbidities were categorized into DKD (CKD with type 1, type 2, or other specified diabetes) and NDMKD (CKD without diabetes) cohorts. Results: Following propensity score matching, 1,498,455 patients were included in each cohort. Compared with NDMKD, DKD patients demonstrated higher risks of acute myocardial infarction (12.7% vs. 7.7%; HR 1.78, 95% CI 1.77–1.79), cerebral infarction (10.4% vs. 7.4%; HR 1.49, 95% CI 1.48–1.50), heart failure (37.1% vs. 25.4%; HR 1.65, 95% CI 1.64–1.65), and atrial fibrillation/flutter (26.9% vs. 22.7%; HR 1.25, 95% CI 1.24–1.26). Renal outcomes were also significantly worse in DKD, with higher rates of dialysis dependence (7.7% vs. 3.6%; HR 2.34, 95% CI 2.32–2.36). Cardiogenic shock (2.6% vs. 1.5%; HR 1.81, 95% CI 1.78–1.84), cardiac arrest (3.3% vs. 2.0%; HR 1.80, 95% CI 1.78–1.83), and all-cause mortality (23.7% vs. 20.0%; HR 1.27, 95% CI 1.26–1.28) were also significantly higher in DKD patients. Median survival times and instance analyses consistently indicated worse outcomes in DKD compared with NDMKD. Conclusion: In this large multinational real-world cohort, patients with DKD experienced significantly higher cardiovascular events, heart failure, arrhythmias, renal replacement therapy dependence, and mortality compared with patients with NDMKD. These findings underscore the additive impact of diabetes on CKD-related complications and highlight the importance of aggressive cardiovascular and renal risk management in patients with DKD.
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