GSB 7.1 Standardlösung

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Diabetic kidney disease

Inadequate control of blood glucose levels can lead to inflammation and damage of the small blood vessels in the kidneys. These changes are termed diabetic nephropathy and are diagnosed by histological examination of kidney tissue (BÄK et al., 2010). Diabetic nephropathy can cause chronic kidney disease, which has several causes apart from diabetes and therefore reflects a broader definition. Hypertension, in particular, is a common comorbidity of diabetes that increases the risk of chronic kidney disease.

Key messages

  • In 2013, 15.1% of adults with diabetes had documented chronic kidney disease.
  • The proportion of people with diabetes and chronic kidney disease increases markedly with age.

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By state


  • By gender


  • By age


  • By education group



In 2013, 15.1% of adults with diabetes presented with documented chronic kidney disease (women: 14.9%; men: 15.3%). This figure increases markedly with age and peaks at 27.9% in the 80-plus age group (women: 26.4%; men: 30.8%).


DaTraV data indicate that one in seven people has impaired kidney function, a figure comparable with DMP data for type 2 diabetes in North Rhine-Westphalia (Zi, 2019. Higher figures are indicated by analyses from RKI studies and DPV registry studies that use laboratory values to estimate kidney function (Du et al., 2015, Bramlage et al., 2019). The higher figures in these studies can be partially explained by the inclusion of people with previously undetected chronic kidney disease. Unlike data from studies, DaTraV data enable a regionalised, time series analysis of chronic kidney disease in patients with diabetes.

Show more information on methodology and data sources


The indicator Diabetic kidney disease is defined as the proportion of persons with diabetes (see Prevalence of documented diabetes indicator) who also present with documented chronic kidney disease (N18.-).

Reference population

Adults are included in the analysis if they have statutory health insurance and documented diabetes (in accordance with the definition of the Prevalence of documented diabetes indicator), have been insured for at least 360 days in the respective year, reside in Germany and have their health benefits fully reimbursed by the statutory health insurance.

Data source

Claims data from approximately all of the 70 million people with statutory health insurance collected in accordance with the Data Transparency Ordinance (DaTraV data). Around 55 million are at least 18 years old, of which around 6.6 million have documented diabetes.


  • Observed relative values: The quotient of the number of people with documented diabetes and documented chronic kidney disease in relation to the population with statutory health insurance and with documented diabetes.
  • Observed absolute values: Number of persons covered by statutory health insurance with documented diabetes and documented chronic kidney disease.
  • Age standardisation: Direct age standardisation used 18- to 24-year-olds as one age group, five-year age groups for the ages 25 to 29 until 80 to 84, and then a separate group for the ages 85 and over. The DaTraV population with documented diabetes in 2013 was used as the reference population.

Data quality

DaTraV data are claims data on all people covered by SHI. DaTraV data include documented outpatient and inpatient diagnoses as well as information on prescribed medications. The quality of claims data from SHI depends on conduct of documentation. DaTraV data do not cover people insured by private health insurance and do not provide information on inpatient or outpatient care.