Enhanced CKM staging improves CKD risk stratification in diabetes. Chronic kidney disease (CKD) often progresses silently in diabetes, and all T2D patients were previously lumped into cardiovascular–kidney–metabolic (CKM) Stage 2. In this study, researchers retrospectively analyzed 600 adults with T2D (final n=600) and defined CKD progression as ≥30% eGFR decline . They compared the original CKM system to two refined versions: one splitting Stage 2 by eGFR and another incorporating KDIGO risk (both eGFR and albuminuria).
Over ~63 months, 86/600 patients (14.3%) reached CKD progression. The fully refined staging (using eGFR+UACR) significantly improved discrimination: AUC rose to 74.3% vs 71.1% (P=0.02), with a positive IDI (P=0.02). Importantly, Stage 2b patients (eGFR 30–59) had about twice the progression incidence of Stage 2a (eGFR ≥60), an effect blunted only when albuminuria was…
