medwireNews: Rates of hospitalization and mortality are increased in people with type 2 diabetes who also have heart failure (HF) or chronic kidney disease (CKD), and more so if they have both conditions, say researchers.
During 2 years of follow-up, just over 7% of people with one of these conditions died in hospital, and this rate doubled, to 14.9%, among those with both HF and CKD.
By contrast, just 1.2% of people with diabetes but no cardiovascular complications died in hospital.
Healthcare costs followed a similar pattern, but whereas medications accounted for the majority of the expense in people without cardiovascular complications, hospital costs made up well over half the healthcare expenses of people with HF and/or CKD.
The researchers used a database covering more than 7 million people to identify those who had type 2 diabetes plus HF (n=7488), CKD (n=3961), both conditions (n=2236), or no major comorbidities (n=326,195). People with HF and/or CKD were approximately 10 years older than those without comorbidities, and were slightly more likely to be male.
Presenting the findings at the virtual ESC Congress 2021, Aldo Maggioni (ANMCO Research Center, Florence, Italy) reported that HF was the most common cause of hospitalization even among people with CKD alone.
In all, 10.6% of these people were hospitalized for HF – fractionally more than the 10.5% who were hospitalized with CKD. And 22.1% of people with both conditions were hospitalized because of HF, whereas CKD was the underlying cause for just 14.3%
Of the people with HF, 14.9% were hospitalized for this condition, and just 2.4% for CKD. Other cardiovascular causes of hospitalization (coronary artery, cerebrovascular, and peripheral artery disease) were rare for all three groups, accounting for 1.3–2.9% of hospitalizations.
Just 1.8% of people who had no cardiovascular comorbidities were hospitalized with HF, but this still made it the most common cause, with others accounting for 0.3–1.0%.
Maggioni concluded that for people with HF and/or CKD “a more efficient treatment strategy – both clinically and economically – may be to adopt a comprehensive approach, embracing cardiovascular, renal and metabolic diseases simultaneously, instead of treating each condition individually.”
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