Chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM) is underdiagnosed. We aimed to evaluate the prevalence of undiagnosed CKD in patients with T2DM and identify factors associated with increased prevalence of CKD.

This cross-sectional study included patients with T2DM presenting for their visit to two centers in Basrah, Southern Iraq. CKD was diagnosed based on the measurement of estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). The association of the patients’ demographic and biochemical characteristics with CKD was analyzed using logistic regression analysis.

Among 1,779 patients (mean age 55.0±11.5 years, 39.0% male, mean T2DM duration 8.9±6.9years), CKD was diagnosed in 887 (49.9%) patients. Specifically, 13.4% had eGFR <60 mL/min/1.73 m²and 45.4% had UACR ≥30 mg/g. Independent predictors of CKD included increasing age (OR 1.03,95% CI 1.02-1.04), longer T2DM duration (OR 1.03, 95% CI 1.01-1.04), elevated HbA1c (OR 1.1, 95% CI1.09-1.19), higher total cholesterol (OR 1.008, 95% CI 1.003-1.01), uncontrolled hypertension (OR 1.4,95% CI 1.03-2.10), and lower HDL cholesterol (OR 0.9, 95% CI 0.9-0.99).

CKD was highly prevalent, affecting almost half of the patients with T2DM. Our findings highlighted the multiple risk factors associated with CKD and emphasized the importance of active CKD screening and comprehensive management strategies.