Introduction and Objective: Type two diabetes (T2D) is a leading cause of chronic renal disease (CKD). Despite strong links between T2D, CKD, and cardiovascular disease (CV), the incidence and timing of major arrhythmias in this high-risk population remains unclear. This study examines the incidence, timing, and risk associated with major arrhythmias in T2D-CKD patients.Methods: We analyzed Symphony Integrated Dataverse (2018-2024) claims data on adults with CKD (stages 1-4) following T2D, assessing arrhythmia occurrence, timing, and metabolic/CV risk factors.Results: Among 3.2M T2D-CKD patients (51% females, median age 73; 49% males, median age 72), 272,644 (20%) developed major arrhythmias, mainly AF. In 59%, arrhythmias preceded CKD (56% males, median age 73; 44% females, median age 74). Median time from T2D to arrhythmia: 488 days (1-2,362); arrhythmia to CKD: 462 days (1-2,368); arrhythmia to MACE: 800 days (2-2,348). When arrhythmias followed CKD (54% males, median age 75; 46% females, median age 76), CKD-to-arrhythmia median time: 355 days (1-2,003). MACE occurred in 17% (54% males, 46% females; median age 76) within three days of arrhythmia, CKD-to-MACE median time: 461 days (1-1,998).Conclusion: Arrhythmias are common in T2D-CKD and strongly linked to MACE. Identifying shared mechanisms between T2D, CKD, and arrhythmias requires innovative diagnostic approaches, including continuous ambulatory EKG monitoring to drive early intervention and precision therapies.
P. Russo: None. R. Nathan: None. V. Jha: None. H. Singh: None. J. Poh: None. K. Boyle: Employee; iRhythm Technologies. E. Hendrickson: Employee; iRhythm Technologies. B. Wright: None.
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