Use of nephroprotective and restricted drugs in patients with type 2 diabetes and renal function impairment attending a low-cost consultation for the first time
DOI:
https://doi.org/10.62954/pmmp7r37Keywords:
diabetes, CKD, nephroprotective agents, cardioprotective agentsAbstract
Introduction: Chronic kidney disease (CKD) is a microvascular complication of type 2 diabetes mellitus (T2DM); its prevalence in Mexico reaches 44%. It is linked to increased cardiovascular risk, so its early approach, detection, and treatment are essential to reduce not only renal morbidity and mortality but also cardiovascular mortality, which is the main cause of death in this disease. Objective: To evaluate the prevalence of renal function impairment and its association with metabolic control, comorbidities, and pharmacological prescription patterns in patients with T2DM attending a low-cost diabetes care center for the first time. Material and methods: A descriptive, observational, and cross-sectional study included patients with a previous diagnosis of T2DM attending a diabetes care center for the first time between 2019 and 2022. Required laboratory tests included fasting plasma glucose (FPG), HbA1c, serum creatinine (SCr), total cholesterol (TC), LDL-C, HDL-C, and triglycerides (TG). The final sample was 908 patients. The CKD-EPI equation and the KDIGO classification were used to estimate the estimated glomerular filtration rate (eGFR). The statistical test used was Chi-square with a significance of 0.05. Results: Only 4.6% of the patients reported a history of CKD. However, the prevalence of reduced renal function with an eGFR <90 mL/min/1.73 m² was 29.6%, while significant deterioration of renal function (eGFR <60 mL/min/1.73 m²) was 7.8%. In the latter group, 73.4% had poor glycemic control. The use of SGLT2 inhibitors and GLP-1 receptor agonists was 16.9% and 1.4%, respectively, while the use of potentially inappropriate drugs according to renal function persisted. Conclusions: The present study reinforces the need to identify renal function impairment earlier and adjust pharmacological treatments, prioritizing the use of nephroprotective agents and limiting those clearly contraindicated in this population.
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Copyright (c) 2026 Rafael Violante-Ortiz, Norma Fernandez-Ordoñez, Dylan Castillo-Hernández, Josue I. Zumaya-García, Jose A. Tovar-Ramírez, Cecilia Cárdenas-Ruiz, José E. Guerra-Cardenas, Elizabeth Reyna-Beltrán, Gabriela G. Guerrero-Suárez (Autor/a)
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