Type 2 diabetes, cardiovascular disease and chronic kidney disease in Hungary: multimorbidity and 11-year survival in a nationwide retrospective study
12 affiliations
- 1Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- 2Novo Nordisk Hungaria Kft, Budapest, Hungary
- 3Center for Pharmacology and Drug Research & Development, Semmelweis University, Budapest, Hungary
- 4Syreon Research Institute, Budapest, Hungary
- 5Bajcsy-Zsilinszky Hospital, Budapest, Hungary
- 62nd Department of Internal Medicine, University of Pécs, Pécs, Hungary
- 7Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- 8Institute for Clinical Data Management, Semmelweis University, Budapest, Hungary
- 9Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Debreceni Egyetem, Debrecen, Hungary
- 10Primary Healthcare Center, Felsőrajk, Hungary
- 11RxTarget Kft, Szolnok, Hungary
- 12Syntesia Medical Communications Ltd, Budapest, Hungary
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.
Design: Nationwide, retrospective, population-based cohort study.
Setting: Hungarian National Health Insurance Fund database; follow-up up to 132 months from 1 January 2013.
Participants: 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.
Interventions: Not applicable (observational study); the exposure was baseline disease status.
Primary 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.
Results: 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.
Conclusions: 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.
Trial registration number: Not applicable.
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BibTeX
@article{somogyi2026type,
title = {{Type 2 diabetes, cardiovascular disease and chronic kidney disease in Hungary: multimorbidity and 11-year survival in a nationwide retrospective study}},
author = {Judit Annamaria Somogyi and Zoltán Vokó and György Jermendy and István Wittmann and Dávid Becker and Loretta Kiss and Maria Papp and László Rosta and György Rokszin and Balázs Babarczy and Zsofia Barcza and Zoltán Polányi and Péter Stella},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-117598},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117598},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Type 2 diabetes, cardiovascular disease and chronic kidney disease in Hungary: multimorbidity and 11-year survival in a nationwide retrospective study
AU - Judit Annamaria Somogyi
AU - Zoltán Vokó
AU - György Jermendy
AU - István Wittmann
AU - Dávid Becker
AU - Loretta Kiss
AU - Maria Papp
AU - László Rosta
AU - György Rokszin
AU - Balázs Babarczy
AU - Zsofia Barcza
AU - Zoltán Polányi
AU - Péter Stella
PY - 2026
DA - 2026/10/27
JO - BMJ Open
DO - 10.1136/bmjopen-2026-117598
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-117598
AB - 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. Design: Nationwide, retrospective, population-based cohort study. Setting: Hungarian National Health Insurance Fund database; follow-up up to 132 months from 1 January 2013. Participants: 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. Interventions: Not applicable (observational study); the exposure was baseline disease status. Primary 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. Results: 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. Conclusions: 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. Trial registration number: Not applicable.
SN - 2044-6055
SN - 2044-6055
ER -