Prevalence and Management Patterns of Chronic Kidney Disease in Patients with Diabetes Mellitus: A Real-World Cross-Sectional Observational Study

Abstract Chronic kidney disease (CKD) is a major complication of diabetes, contributing to increased risks of kidney failure, cardiovascular events, and mortality. Current management emphasizes early detection and use of cardio-renal protective therapies. A cross-sectional, questionnaire-based survey was conducted among practicing clinicians managing diabetes and CKD. A structured 12-item questionnaire assessed clinician-reported CKD prevalence, stage distribution, patient profile, treatment preferences, hemodialysis management, and finerenone use. Data were analyzed descriptively and reported as percentages. Most clinicians reported CKD prevalence of 11 to 20% among patients with diabetes. Early-stage disease predominated, with Stage 2 and Stage 3 CKD most commonly encountered, while advanced stages were less frequent. CKD was most often observed in patients aged 31 to 50 years, and type-2 diabetes was identified as the primary contributor. SGLT2 inhibitors were the preferred first-line therapy, and combination regimens commonly included angiotensin-converting enzyme (ACE) inhibitors/angiotensin II receptor blockers. In hemodialysis, SGLT2 inhibitors and insulin were most frequently used. Finerenone was prescribed by a majority of clinicians, typically guided by cardiovascular risk and renal function, and was most commonly used in earlier CKD stages. Most respondents anticipated increased future use of Finerenone. CKD in diabetes is commonly encountered at earlier stages, with a growing preference for cardio-renal protective therapies, particularly SGLT2 inhibitors and finerenone. These findings reflect evolving clinical practice patterns and highlight the need for broader implementation of guideline-directed screening and risk-based management strategies.