Rate of decline in kidney function and known age-of-onset or duration of type 2 diabetes

The association between rate of kidney function decline and age-of-onset or duration of diabetes has not been well investigated. We aimed to examine whether rates of estimated glomerular filtration rate (eGFR) decline differ by age-of-onset or duration in people with type 2 diabetes. Using the Action to Control Cardiovascular Risk in Diabetes study which included those with HbA1c >= 7.5% and who were at high risk of cardiovascular events,, rates of eGFR decline were calculated and were compared among groups defined by the known age-of-onset (0-39, 40-49, 50-59, 60-69 and>70 years) and 5-year diabetes duration intervals. Changes in renal function were evaluated using median of 6 (interquartile range 3-10) eGFR measurements per person. eGFR decline was the slowest in those with known age-at-diagnosis of 50-59 years or those with duration of diabetes<5 years. The rates of eGFR decline were significantly greater in those with known age-of-onset<40 years or those with duration of diabetes>20 years compared to those diagnosed at 50-59 or those with duration of diabetes<5 years (- 1.98 vs - 1.61 mL/min/year; - 1.82 vs - 1.52 mL/min/year; respectively (p<0.001). Those with youngest age-of-onset or longer duration of diabetes had more rapid declines in eGFR compared to those diagnosed at middle age or those with shorter duration of diabetes.