In recent years, the global prevalence of diabetes has risen significantly. According to the 9th edition of the International Diabetes Federation Atlas, an estimated 463 million adults were living with diabetes in 2019, representing approximately 9.3% of the population, with an average annual increase of 51%.

Diabetes is associated with multiple complications that can significantly impact patient outcomes . In 2019 alone, around 4.2 million deaths were attributed to diabetes and its complications, accounting for approximately 11.3% of all global deaths .

In diabetic patients, several factors influence renal survival, including glycemic control, blood pressure management, lifestyle interventions, and pharmacological therapies such as renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-glucose co-transporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists(9). Early detection of kidney dysfunction through biomarkers like estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) plays a pivotal role in improving renal outcomes.

This study aims to evaluate the factors affecting Patients survival in diabetic patients, identify early predictors of renal function decline, and assess the effectiveness of current therapeutic strategies.

Inclusion Criteria:

• ● Patients age > 18 years old

  • Both sex
  • diabetic patients with HbA1c level >6.5( Type 1 and 2)
  • Diabetic patients with CKD 4, 5 )
  • HD Pt

Exclusion Criteria:

• ● Chronic kidney diseases stage 1,2, and 3.

  • Acute kidney injury.
  • Patients with any other causes of CKD autoimmune disease

diabetic patients with chronic kideny disease stage 4,5