In the LiteratureKidney Disease in People With Diabetes: The Expanding Epidemic
Section snippets
What Does This Important Study Show?
de Boer et al1 analyzed data from NHANES III (Third National Health and Nutrition Examination Survey) conducted in 1988-1994 and the continuous NHANES (1999-2008) to investigate trends in CKD in people with diabetes. This study found that the prevalence of CKD in people with diabetes has increased during the past 2 decades and has done so in proportion to the increasing prevalence of diabetes. This is in contrast to the recent plateau in rates of diabetic end-stage renal disease (ESRD).
The
How Does This Study Compare With Prior Studies?
These results extend previous studies, which also have shown an increasing burden of CKD in the United States.10, 11, 12 Diabetes is a leading cause of CKD, and the prevalence of diagnosed diabetes has increased from 5.1% (NKF-KDOQI3) to 11.9% in the past 20 years in the United States.13 However, the prevalence of undiagnosed diabetes has remained relatively constant during this period.14 Trends in diabetes prevalence reflect the lowering of the diagnostic threshold for fasting glucose level
What Should Clinicians and Researchers Do?
The major message from this study1 is the absolute increase in burden of diabetic kidney disease, which mirrors the increase in diabetes prevalence. These data raise the concern that the plateau in rate of ESRD in people with diabetes may be temporary and may increase as the dual epidemics of obesity and diabetes mature because the lag time from onset of diabetes to ESRD typically is 2 decades or more. Clinicians should optimize treatment of diabetes to prevent the onset of diabetic nephropathy
Acknowledgements
Mr Juraschek was supported by NIH/NHLBI grant T32 HL007024.
Financial Disclosure: Dr Coresh has consulted for Amgen and Merck and has an investigator-initiated grant on CKD prognosis analyses from Amgen. The remaining authors declare that they have no relevant financial interests.
References (18)
- et al.
Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey
Am J Kidney Dis
(2003) - et al.
Temporal trends in the prevalence of diabetic kidney disease in the United States
JAMA
(2011) - et al.
A new equation to estimate glomerular filtration rate
Ann Intern Med
(2009) K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: evaluation, classification, and stratification
Am J Kidney Dis
(2002)- et al.
National trends in treatment of type 2 diabetes mellitus, 1994-2007
Arch Intern Med
(2008) - et al.
The intensification of drug therapy for diabetes and its complications: evidence from 2 HMOs
Am J Manag Care
(2004) - et al.
Physician conformity and patient adherence to ACE inhibitors and ARBs in patients with diabetes, with and without renal disease and hypertension, in a medicaid managed care organization
J Manag Care Pharm
(2006) - et al.
End-stage renal disease in the United States: an update from the United States Renal Data System
J Am Soc Nephrol
(2007) - et al.
Decreased muscle strength and quality in older adults with type 2 diabetes: the Health, Aging, and Body Composition Study
Diabetes
(2006)
Cited by (4)
Angiotensinogen and Risk of Stroke Events in Patients with Type 2 Diabetes Mellitus
2022, Diabetes, Metabolic Syndrome and ObesityRisk prediction of major complications in individuals with diabetes: the Atherosclerosis Risk in Communities Study
2016, Diabetes, Obesity and MetabolismRenoprotective effect of atorvastatin on STZ-diabetic rats through inhibiting inflammatory factors expression in diabetic rat
2016, European Review for Medical and Pharmacological SciencesMicrobubbles and ultrasound: Therapeutic applications in diabetic nephropathy
2016, Advances in Experimental Medicine and Biology
Originally published online December 12, 2011.