Global prevalence of chronic kidney disease in type 1 diabetes: A systematic review and meta‐analysis

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Abstract Aims The burden of type 1 diabetes (T1D)‐related chronic kidney disease (CKD) continues to grow and demands attention. We aim to determine the global prevalence of CKD in T1D. Materials and Methods PubMed, Embase, Cochrane Library and Web of Science were searched from database inception to 23 May 2025. Grey literature and reference lists of relevant articles were also retrieved. Observational studies with at least 100 participants reporting the prevalence of CKD in T1D were included. In line with the Meta‐analysis of Observational Studies in Epidemiology (MOOSE) guidelines, data from eligible studies were extracted by two independent reviewers using a standardised form, with risk of bias assessed. A random‐effects model was applied for the meta‐analysis. The primary outcome was the pooled prevalence. Secondary outcomes included the pooled prevalence stratified by study design, region, age, diabetes duration and glycated haemoglobin (HbA 1c ), along with separate univariable meta‐regressions for diabetes duration and for HbA 1c . Results Our search identified 2187 studies; 19 met criteria and were included in the meta‐analysis. The overall pooled prevalence of CKD in T1D from 1 371 533 individuals was 22.3% (95% CI 18.9%–26.0%). Regional analysis showed the highest prevalence in the Americas (27.0%, 95% CI 21.8%–33.0%) and the lowest in Europe (19.4%, 95% CI 15.0%–24.7%). The prevalence was higher in adults (20.5%, 95% CI 18.0%–23.3%) than in adolescents (10.5%, 95% CI 7.4%–14.8%), in those with diabetes duration ≥10 years (21.8%, 95% CI 16.9%–27.7%) than in those with a shorter duration (16.4%, 95% CI 15.5%–17.3%), and in those with HbA 1c ≥ 8% (27.7%, 95% CI 21.8%–34.6%) than in those with better glycemic control (17.9%, 95% CI 13.8%–22.9%). Meta‐regression revealed a significant association between CKD prevalence in T1D and higher HbA 1c levels. High heterogeneity was observed among studies, with no studies at high risk of bias. Conclusions Our study found a high prevalence of CKD in T1D, and poor glycemic control increases the prevalence. Regular screening in T1D is necessary to reduce the risk of severe kidney disease.

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