Prevalence, screening and treatment of chronic kidney disease in people with type 2 diabetes in France: The ENTRED surveys (2001 and 2007)

Aims. - The study aimed to assess the prevalence, quality of screening and treatment of chronic kidney disease (CKD), and their trends between 2001 and 2007, in French adults with type 2 diabetes (T2D). Methods. - The 2007 ENTRED survey randomly selected, from French medical insurance fund databases, 8926 adults treated for diabetes who had been reimbursed at least three times over the previous 12 months for oral hypoglycaemic agents or insulin. Medical reimbursement data were extracted and two sets of questionnaires were mailed, one to all patients (48% response rate) and the other to their doctors (62%). Analyses were restricted to the 3894 responders with T2D (2232 with data from their doctors). Trends between the 2001 and 2007 ENTRED surveys were studied. Results. - Participants' mean age was 66 years. The prevalence of CKD was estimated to be at least 29%, based on doctors' data (missing data included). Overall, only 17% had no claims for serum creatinine measurements during the year, and 71% had no claims for albuminuria tests; nonetheless, both figures had decreased from 2001. Older people, those who lived alone and those who felt poorly informed about diabetes were more likely to have made no claims for CKD screening. Assessment of quality of care (prescribing antihypertensive treatment when indicated) was possible for 66% of responders, of whom 25% did not receive such treatment. Conclusion. - CKD is frequently seen in patients with T2D and is likely to be underestimated because albuminuria screening remains inadequate, despite significant improvements since 2001. Further efforts are needed to improve CKD screening, patient and doctor awareness, and adequate use of antihypertensive/nephroprotective medications. (C) 2012 Elsevier Masson SAS. All rights reserved.