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A Retrospective Analysis of the Relationship Between Comorbid Hypertension and Diabetes and Recent Chronic Kidney Disease Diagnosis

Russell H. Wendt, Jose H. Salazar, Niti Vyas and Muneeza Esani
American Society for Clinical Laboratory Science January 2025, 38 (1) 34-40; DOI: https://doi.org/10.29074/ascls.2025003298

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  • Table 1.

    International Classification of Diseases, Tenth Revision codes for CKD

    CodeStage of DiseaseSeverity Level
    N18CKD
    N18.1CKD, stage 1
    N18.2CKD, stage 2Mild
    N18.3CKD, stage 3Moderate
    N18.30CKD, stage 3Unspecified
    N18.31CKD, stage 3a
    N18.32CKD, stage 3b
    N18.4CKD, stage 4Severe
    N18.5CKD, stage 5
    N18.6ESRD
    N18.9CKDUnspecified
    E08.22Diabetic CKD
    E09.22Diabetic CKD
    E10.22Diabetic CKD
    E11.22Diabetic CKD
    E13.22Diabetic CKD
    I12Hypertensive CKD
    I12.0Hypertensive CKD with stage 5 CKD or ESRD
    I12.9Hypertensive CKD, stage 1–4 or unspecified

    Reprinted from “ICD-10-CM Codes > N00-N99 > N17-N19 > Chronic kidney disease (CKD) N18,” retrieved from https://www.icd10data.com/ICD10CM/Codes/N00-N99/N17-N19/N18-.

    Abbreviations: CKD, chronic kidney disease; ESRD, end-stage renal disease.

    • Table 2.

      Demographics and bivariate analyses

      VariablesTotal n (%) N = 1,000CKD1 Cases
      n (%) N = 500      		Controls: No CKD
      n (%) N = 500      		P Value
      Gender.75a
       Male411 (41.1)208 (41.6)203 (40.6)
       Female589 (58.9)292 (58.4)297 (59.4)
      Race.004*a
       White787 (78.7)371 (74.2)416 (83.2)
       Black189 (18.9)118 (23.6)71 (14.2)
       Other24 (2.4)11 (2.2)13 (2.6)
      Ethnicity<.001*a
       Hispanic or Latino212 (21.2)77 (15.4)135 (27.0)
       Not Hispanic or Latino778 (77.8)420 (84.0)358 (71.6)
       Unknown10 (1.0)3 (0.6)7 (1.4)
      Smoking status.06a
       Yes198 (19.8)97 (19.4)101 (20.2)
       No636 (63.6)306 (61.2)323 (64.6)
       Unknown166 (16.6)97 (19.4)76 (15.2)
      History of diabetes<.001*a
       Yes287 (28.7)188 (37.6)99 (19.8)
       No713 (71.3)312 (62.4)401 (80.2)
      History of hypertension<.001*a
       Yes663 (66.3)412 (82.4)251 (50.2)
       No337 (33.7)88 (17.6)249 (49.8)
      History of comorbid diabetes and hypertension<.001*a
       Yes260 (26.0)174 (34.8)86 (17.2)
       No740 (74.0)326 (65.2)414 (82.8)
      Additional VariablesTotal Mean (SD)CKD Cases Mean (SD)Controls: No CKD Mean (SD)P Value
      Age64.0 (16.5)68.4 (12.0)54.8 (17.1)<.001*b
      Median income by zip ($)78,588 (24,855)78,227 (24,030)78,950 (25,672).65b
      BMI31.42 (8.01)31.50 (7.92)31.35 (8.11).77b
      Charlson Comorbidity Index1.8 (2.2)2.6 (2.5)1.0 (1.5)<.001*b

      Abbreviations: BMI, body mass index; CKD, chronic kidney disease.

      • ↵a Performed using Phi coefficient correlation.

      • ↵b Performed using point biserial correlation.

    • Table 3.

      Bivariate analyses between CKD and additional variables

      VariablesTotal Mean (SD)CKD Cases Mean (SD)Controls CKD Mean (SD)P Valuea
      Serum albumin (g/dL)4.2 (0.4)4.1 (0.4)4.3 (0.4)<.001*
      Urine albumin (mg/g)230.1 (948.8)248.7 (757.7)203.3 (1181.8).75
      Serum calcium (mg/dL)9.3 (0.6)9.3 (0.6)9.3 (0.5).24
      Urine creatinine (mg/dL)112.9 (79.2)112.4 (80.8)113.9 (76.5).88
      Serum creatinine (mg/dL)1.13 (0.72)1.44 (0.87)0.83 (0.34)<.001*
      Hemoglobin A1C (%)6.3 (1.6)6.8 (1.8)6.0 (1.3)<.001*
      Absolute lymphocyte count (109 cells/L)1.89 (0.83)1.78 (0.88)1.95 (0.80).006*
      Absolute neutrophil count (109 cells/L)4.98 (2.75)5.14 (3.01)4.88 (2.52).20
      Phosphorus (mg/dL)3.9 (1.0)3.9 (0.9)3.6 (1.1).25
      Sedimentation rate (mm/hour)36 (33)45 (37)32 (30).17
      White blood cell count (109 cells/L)7.71 (2.94)7.98 (3.13)7.65 (2.78).46
      Neutrophil:lymphocyte ratio3.51 (5.33)3.83 (4.63)3.29 (5.75).18

      Abbreviation: CKD, chronic kidney disease.

      • ↵a Performed using point biserial correlation.

    • Table 4.

      Logistic regression models for HTN1 only (N = 687)

      VariableORP Value95% CI
      Age1.056<.001*1.043–1.070
      Racea,b1.557.0590.984–2.464
      African American race1.717.029*1.057–2.791
      Hispanic ethnicity0.623.0650.376–1.030
      HTN2.732<.001*1.872–3.986

      Abbreviation: HTN, hypertension.

      • ↵a Referent race is White.

      • ↵b Other racial categories combined due to having <10 members each.

    • Table 5.

      Logistic regression for diabetes only (N = 337)

      VariableOdds RatioP Value95% CI
      Age1.055<.001*1.035–1.074
      Racea,b1.169.7080.517–2.643
      African American race1.082.8670.428–2.739
      Hispanic ethnicity0.632.6650.063–5.814
      Diabetes2.180.021*1.127–4.216

      • ↵a Referent race is White.

      • ↵b Other racial categories collapsed because of each having <10 members each.

    • Table 6.

      Logistic regression for comorbid HTN1 and diabetes (N = 544)

      VariableOdds
      Ratio      		P Value95% CI
      Age1.052<.001*1.037–1.068
      Racea,b1.574.0870.936–2.648
      African American race1.702.0620.973–2.977
      Hispanic ethnicity0.828.4580.502–1.364
      Comorbid HTN and diabetes3.519<.001*2.287–5.414

      Abbreviation: HTN, hypertension.

      • ↵a Referent race is White.

      • ↵b Other racial categories collapsed because of each having <10 members.

    • Table 7.

      Logistic regression models for all other significant variables (N = 386)

      GFR as Continuous VariableGFR as Dichotomous Variable (<90)
      VariableORP Value95% CIORP Value95% CI
      Age (years)1.051.004*1.016–1.0871.058<.001*1.034–1.082
      Racea0.597.2370.254–1.4031.306.4290.674–2.532
      African American race1.901.1540.786–4.6001.299.4550.654–2.582
      Hispanic ethnicity2.274.1390.765–6.7571.179.6630.562–2.472
      Hemoglobin A1C (%)1.320.027*1.032–1.6881.328.003*1.100–1.604
      Serum albumin (g/dL)1.660.3450.580–4.7490.467.038*0.227–0.960
      Absolute lymphs (109 cells/L)1.110.6870.669–1.8421.095.5830.792–1.516
      eGFR (mL/min/1.73 m2)0.889<.001*0.864–0.914
      eGFR <90 (mL/min/1.73 m2)57.596<.001*7.609–435.978

      • ↵a Referent race is White; all non-White racial categories combined.

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    A Retrospective Analysis of the Relationship Between Comorbid Hypertension and Diabetes and Recent Chronic Kidney Disease Diagnosis
    Russell H. Wendt, Jose H. Salazar, Niti Vyas, Muneeza Esani
    American Society for Clinical Laboratory Science Jan 2025, 38 (1) 34-40; DOI: 10.29074/ascls.2025003298
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