Prevalence, Incidence and Mortality of Chronic Kidney Disease in Type 1 and Type 2 Diabetes-A Nationwide Danish Register-Based Cohort Study.

AIMS: Chronic kidney disease (CKD) remains a leading complication of diabetes, and understanding population-level trends is crucial for prevention and healthcare planning. We examined national trends in CKD prevalence, incidence, and mortality among people with diabetes. METHODS: In this nationwide register-based cohort study, we identified people with diabetes in Denmark between 2016 and 2024 using linked national registers. CKD was defined by ≥ 2 measurements of estimated glomerular filtration rate < 60 mL/min/1.73 m2 and urinary albumin-creatinine ratio ≥ 30 mg/g, or a hospital diagnosis or procedure code. Annual CKD prevalence was calculated on 1 January each year. CKD incidence and mortality rates were calculated annually and reported per 1000 person-years (PY), separately for type 1 diabetes (T1D) and type 2 diabetes (T2D) and stratified by sex and age. RESULTS: Between 2016 and 2024, CKD prevalence increased from 20.5% to 26.4% in T1D and from 24.8% to 37.3% in T2D. CKD incidence declined from 21.5 to 14.9 per 1000 PY in T1D and from 55.3 to 43.7 per 1000 PY in T2D, with the largest reductions in older people (aged ≥ 70 years with T2D [93.6 to 74.3 per 1000 PY]). Albuminuria prevalence increased, whereas incidence declined in both diabetes types. Mortality declined in people with and without CKD but remained substantially higher among those with CKD. CONCLUSION: From 2016 to 2024, CKD incidence declined while prevalence increased among people with diabetes in Denmark. Mortality remained high among people with CKD, highlighting the ongoing clinical burden and need for improved prevention and early detection.