Premature mortality in individuals living with type 2 diabetes in Jalisco, Mexico, 2011-2019.

Abstract

Objective: To estimate survival outcomes in a population living with diabetes, screened for chronic kidney disease (CKD) and to describe characteristics associated with premature mortality using data from an administrative cohort in Jalisco, Mexico.

Materials and methods: Using an administrative cohort design, we investigated the 8-year cumulative mortality associated with CKD. We linked screening with mortality data and described population characteristics by CKD stage, computed years of life lost (YLL), and performed Kaplan-Meier curves and Cox proportional hazard models to analyze survival and mortality risk factors.

Results: At screening, 44% of the cohort exhibited impaired renal function. The mortality rate stood at 14%, 2.5% linked to CKD; 8.7% were premature deaths, accumulating 8 036 YLL. Eight-year survival was 93% for individuals with normal renal function at screening, decreasing to 41% for those with glomerular filtration rate below 30 mL/min/1.73m², albumin-creatinine ratio >300 mg/dl, increased years since diabetes diagnosis, hypertension, amputations, retinopathy, and smoking were associated with higher mortality risk; female sex and obesity with a lower risk.

Conclusion: The high prevalence of renal impairment in this cohort and its association with high mortality underscores the critical importance of timely detection and protocolized intervention for CKD to mitigate this burden.