Knowledge on prevalence, comorbidities and consequences of chronic kidney disease (CKD)
is mandatory to estimate the potential of cardiovascular risk management on a population level. We studied
the prevalence of CKD with or without type 2 diabetes mellitus (T2D) and/or heart failure and its cardiorenal
complications in The Netherlands.
Methods A descriptive cross-sectional and longitudinal cohort study was performed, using data from the Dutch
PHARMO Data Network. Prevalence of CKD at a single time point was determined by a recorded diagnosis or by ≥2
estimated glomerular filtration rate (eGFR) measurements and urine albumin/creatinine ratio (UACR) that define CKD.
A representative group of adults with CKD was included in a longitudinal analysis to study cardiorenal complications.
Those were followed until first complication, end of study or death, whichever occurred first.
Results The prevalence of CKD was 8.9% in a representative population of 2,187,962 adult Dutch individuals. The
average age of persons with CKD was 72 years, 57% were female, 19.9% had T2D, 7.7% heart failure, and 3.0% both
T2D and heart failure. In the longitudinal analysis, cerebrovascular events (11/1,000 person-years), hospitalizations
for heart failure (10/1,000 person-years), myocardial infarction (5.5/1,000 person-years), and hospitalization for CKD
(6.2/1,000 person-years) were the most common first cardiorenal complications. People with CKD with T2D and/or
heart failure generally had higher rates of cardiovascular or renal complications or mortality than people with CKD
without these comorbidities.
Conclusion The prevalence of CKD in The Netherlands is 8.9%. People with T2D or heart failure, or both, in
addition to CKD, had numerically higher mortality and cardiorenal complication rates than people without these
comorbidities. Optimizing up-to-date cardiovascular risk management in these high-risk individuals may provide
health benefits.
Keywords Cardiorenal Complications, Chronic Kidney Disease, Diabetes Mellitus, Heart Failure, Prevalence