Evidence mapPaperPMID 42564101Full record

ArticleFrontiers in endocrinology2026

Clustering-derived clinical subtypes and outcomes of chronic kidney disease in patients with diabetes: a multicenter cohort study.

Jeong-Yeun Lee, Hyunjee Kim, Dong Keon Yon, Jung Pyo Lee, Sang Youl Rhee, Soie Kwon, Seokwoo Park, Yaerim Kim, Hyeon Seok Hwang

Abstract readMulticenter Study
In one paragraph

Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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9 authors.

Jeong-Yeun Lee *Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, Republic of Korea.
Hyunjee Kim *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Dong Keon Yon *Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Jung Pyo LeeDepartment of Internal Medicine-Nephrology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Sang Youl RheeCenter for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Soie KwonDepartment of Internal Medicine-Nephrology, Chung-Ang University Hospital, Seoul, Republic of Korea.
Seokwoo ParkDepartment of Internal Medicine-Nephrology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea.
Yaerim KimDepartment of Internal Medicine-Nephrology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
Hyeon Seok HwangDivision of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Chronic kidney disease (CKD) with diabetes is a heterogeneous condition with multiple underlying causes. However, no classification system appropriately captures the diversity of patients with CKD and diabetes or provides prognostic insights. Methods: We included 11,925 patients with CKD and diabetes from the Multicenter Cohort of Diabetic Kidney Disease Study (MEET-DKD) between 2000-2023. K-means clustering was implemented using thirty-two variables to identify the subtypes of CKD with diabetes. The associations between subtypes and cardiovascular events, progression to end-stage kidney disease (ESKD), and mortality were evaluated. Results: Three distinct diabetic CKD subgroups were identified; cluster 1 (n=4,494 [37.7%]) included predominantly older patients with multiple comorbidities and the highest medication use (comorbidity-dominant subtype); cluster 2 (n = 2,240 [18.8%]) included patients with lower renal function, and a moderate burden of comorbidities and medications (advanced CKD subtype); and cluster 3 (n = 5,191 [43.5%]) comprised patients with a higher prevalence of obesity, fewer comorbidities, and comparatively favorable laboratory profiles (obesity-dominant subtype). Compared with the obesity-dominant subtype, the comorbidity-dominant subtype exhibited the highest mortality risk (hazard ratio, 1.48; 95% confidence interval, 1.37-1.59). For progression to ESKD, using the comorbidity-dominant subtype as the reference, the advanced CKD subtype showed the highest risk (hazard ratio, 1.46; 95% confidence interval, 1.31-1.64). Similarly, compared with the comorbidity-dominant subtype, the obesity-dominant subtype showed the greatest risk of cardiovascular events (hazard ratio, 1.47; 95% confidence interval, 1.32-1.64). Conclusion: Our study identified three distinct subgroups of diabetic patients with CKD with differential risks for major outcomes. This highlights the heterogeneity of CKD in patients with diabetes, and suggest that identified subtypes may provide additional prognostic information for risk stratification. Further external validation is required before clinical implementation.

Indexed as

Diabetic NephropathiesRenal Insufficiency, ChronicAgedCluster AnalysisClustering AlgorithmsCohort StudiesComorbidityDisease ProgressionFemaleHumansKidney Failure, ChronicMaleMiddle AgedPrognosischronic kidney diseaseclustering analysisdiabetesend-stage kidney diseasesubtyping

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PMID42564101
PMCPMC13441787

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.