{
  "abstract": "Objectives: To examine the prevalence in Hungary of selected cardiovascular-kidney-metabolic (CKM) conditions (type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and chronic kidney disease (CKD)) and their combinations and to assess 11-year overall survival (OS) by baseline disease status.\n\nDesign: Nationwide, retrospective, population-based cohort study.\n\nSetting: Hungarian National Health Insurance Fund database; follow-up up to 132 months from 1 January 2013.\n\nParticipants: Patients aged ≥20 years with International Classification of Diseases, 10th Revision codes for T2DM, CVD or CKD recorded between 1 January 2011 and 31 December 2012 and alive on 1 January 2013.\n\nInterventions: Not applicable (observational study); the exposure was baseline disease status.\n\nPrimary and secondary outcome measures: Point prevalence of T2DM, CVD, CKD and their combinations by age and sex on 1 January 2013, OS by baseline disease status (Cox proportional hazards models, with disease status fixed at baseline throughout follow-up) and longitudinal changes in health status within each baseline cohort.\n\nResults: On 1 January 2013, 1 059 087 patients (13.4% of the population aged ≥20 years) had a T2DM, CVD or CKD diagnosis recorded in the previous 2 years; 211 549 (20%) were multimorbid. At 132 months, patients with stand-alone T2DM, CVD or CKD had age- and sex-standardised OS rates of 54.2%, 53.8% and 44.3%, respectively. Coexistence of all three conditions was associated with an 11-year OS of 21.0% (median OS: 62 months). Male sex, older age and additional comorbidities were associated with significantly higher risks of death.\n\nConclusions: A substantial proportion of patients with T2DM, CVD or CKD, alone or in combination, developed additional comorbidities or died during follow-up, including in younger age groups. The frequent coexistence of these conditions and the steep survival gradient across them support the rationale for the CKM syndrome framework.\n\nTrial registration number: Not applicable.",
  "abstract_shown": true,
  "affiliations": [
    "Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary",
    "Novo Nordisk Hungaria Kft, Budapest, Hungary",
    "Center for Pharmacology and Drug Research & Development, Semmelweis University, Budapest, Hungary",
    "Syreon Research Institute, Budapest, Hungary",
    "Bajcsy-Zsilinszky Hospital, Budapest, Hungary",
    "2nd Department of Internal Medicine, University of Pécs, Pécs, Hungary",
    "Heart and Vascular Center, Semmelweis University, Budapest, Hungary",
    "Institute for Clinical Data Management, Semmelweis University, Budapest, Hungary",
    "Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Debreceni Egyetem, Debrecen, Hungary",
    "Primary Healthcare Center, Felsőrajk, Hungary",
    "RxTarget Kft, Szolnok, Hungary",
    "Syntesia Medical Communications Ltd, Budapest, Hungary"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
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        1,
        2
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      "name": "Judit Annamaria Somogyi",
      "orcid": "0009-0003-3259-1386"
    },
    {
      "affs": [
        0,
        2,
        3
      ],
      "name": "Zoltán Vokó"
    },
    {
      "affs": [
        4
      ],
      "name": "György Jermendy"
    },
    {
      "affs": [
        5
      ],
      "name": "István Wittmann",
      "orcid": "0000-0001-5163-5733"
    },
    {
      "affs": [
        6
      ],
      "name": "Dávid Becker"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Loretta Kiss"
    },
    {
      "affs": [
        8
      ],
      "name": "Maria Papp"
    },
    {
      "affs": [
        9
      ],
      "name": "László Rosta"
    },
    {
      "affs": [
        10
      ],
      "name": "György Rokszin"
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    {
      "affs": [
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        2,
        3
      ],
      "name": "Balázs Babarczy"
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    {
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        11
      ],
      "name": "Zsofia Barcza",
      "orcid": "0000-0001-7708-1994"
    },
    {
      "affs": [
        1
      ],
      "name": "Zoltán Polányi"
    },
    {
      "affs": [
        1
      ],
      "name": "Péter Stella"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ajckt80egfcce.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjopen-2026-117598",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723811/",
  "id": "ajckt80egfcce",
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    "2044-6055"
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  "landing_url": "https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117598",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
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  "native_subjects": [
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      "heading",
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    [
      "openalex",
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  "pmcid": "PMC13723811",
  "pmid": "42946358",
  "published": "2026-10-27",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/ajckt80egfcce.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:44Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Epidemiology",
      "subfield": "epidemiology-public-health"
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  ],
  "title": "Type 2 diabetes, cardiovascular disease and chronic kidney disease in Hungary: multimorbidity and 11-year survival in a nationwide retrospective study",
  "title_text": "Type 2 diabetes, cardiovascular disease and chronic kidney disease in Hungary: multimorbidity and 11-year survival in a nationwide retrospective study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:33Z",
  "url": "https://research.draconitic.com/paper/ajckt80egfcce",
  "venue": "BMJ Open",
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