Table 20 Findings of the replicated studies compared to our results

Main findings: The use of antidiabetic and antihypertensive medications generally followed treatment guideline recommendations:

The use of metformin was significantly limited with increasing CKD severity

The use of insulin increased sharply in severe CKD stages

Antihypertensive medications were used extensively

The level of RAAS inhibitor (including ACE inhibitors and ARBs) use was consistent, even in patients without CKD and with mild-to-moderate CKD

Use of thiazide diuretics was more prevalent than other diuretic agents with mild-to-moderate CKD

Thiazide diuretics were replaced by loop diuretics among those with moderate CKD to kidney failure

Other findings

Antidiabetes medications:

Overall, 83.1% of individuals with T2DM received antidiabetic medications

The use of insulin, biguanide (metformin), and sulfonylurea (SU) was significantly different between patients without CKD, those with mild-to-moderate CKD, and those with moderate CKD to kidney failure

The use of dipeptidyl peptidase-4 (DPP-4) inhibitors was similar

The use of sulfonylurea (SU)s increased in later CKD stages (3b and 4)

Sulfonylurea SU use dropped in CKD stage 5

Antihypertensive medications:

Overall, 75.7% of individuals with T2DM received antihypertensive medications

Use was extensive in those with CKD stage 2 or higher

Fewer than two-thirds were taking some form of RAAS inhibitor

There was a difference in the use of ACE inhibitors and ARBs between patients without CKD, those with mild-to-moderate CKD, and those with moderate CKD to kidney failure

The use of β-blockers, diuretics, and CCBs was statistically different

ARBs appeared to be more commonly used in stages 3a–4

The use of β-blocker and CCBs trended upward with increasing CKD severity

Diuretic use also increased from stage 1 through stage 4, but sharply fell in stage 5

Dhiazide diuretics were more commonly used by individuals without CKD or with mild-to-moderate CKD compared with other diuretic subclasses

In later CKD stages, the dominance of thiazide diuretics was replaced with loop diuretics

β-Blocker use increased with stages 4 and 5 CKD