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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Diabetes is one of the major causes of chronic kidney disease (CKD) and a significant determinant of prognosis in patients with advanced CKD. However, evidence on its impact on mortality and kidney replacement therapy (KRT) among Japanese patients with advanced CKD remains limited. Using data from the nationwide, multicenter, prospective REACH-J-CKD cohort, we examined the association between diabetes and adverse outcomes, including all-cause mortality and progression to KRT.
The REACH-J-CKD study enrolled 2,249 non-dialysis patients with CKD stages G3b–G5 from 31 centers across Japan using stratified random sampling. Of these, 2,146 patients with documented diabetes status were included. Patients with missing data on albuminuria or proteinuria stage (n = 499) were excluded, leaving 1,647 patients for analysis. Albuminuria category (A category, A1, A2, and A3) was determined using either albuminuria or proteinuria data according to the KDIGO guidelines. Baseline characteristics, comorbidities, and laboratory data were collected. Diabetes was defined by a documented medical history. The primary outcome was a composite of all-cause mortality or initiation of kidney replacement therapy (KRT), including dialysis and transplantation. Kaplan–Meier analysis and Cox proportional hazards models adjusted for age, sex, eGFR, diabetes, albuminuria stage, and use of RAS inhibitors were performed.
Among the 1,647 patients, 544 (33.0%) had diabetes. Compared with non-diabetic patients, those with diabetes had a lower eGFR (20.1 vs. 22.6 mL/min/1.73 m², p = 0.001) and a higher prevalence of A3 category (70.2% vs. 55.5%, p < 0.001). They were older (71 vs. 69 years), more likely to be male (72.8% vs. 60.6%), and had higher frequencies of hypertension, dyslipidemia, and a history of cardiovascular disease. Among all patients, diabetic kidney disease (DKD) was identified as the primary renal diagnosis in 20.5%, and 1.4% of these underwent renal biopsy. During a median follow-up of 4.73 years, 797 composite events (48.4%) occurred, with significantly higher rates in the diabetes group (57.2%) than in the non-diabetes group (44.1%) (Log-rank p < 0.0001). Kaplan–Meier curves showed an early and clear divergence between the groups. In the multivariable Cox model, diabetes was independently associated with an increased risk of the composite outcome (HR 1.22, 95% CI 1.05–1.41, p = 0.0083). Albuminuria severity was also a strong prognostic factor, with HRs of 1.89 (95% CI 1.44–2.49, p < 0.0001) for A3 vs A1 and 2.17 (95% CI 1.78–2.66, p < 0.0001) for A3 vs A2.
In Japanese patients with advanced CKD, diabetes was a significant and independent risk factor for all-cause mortality or progression to KRT. In addition, severe albuminuria strongly predicted poor outcomes. These findings highlight the importance of intensive risk management and early intervention in advanced CKD patients with diabetes to improve prognosis.
