Epidemiology of diabetic kidney disease

Med Clin North Am. 2013 Jan;97(1):1-18. doi: 10.1016/j.mcna.2012.10.001.

Abstract

The increasing prevalence of diabetes has led to DKD becoming the leading cause of ESRD in many regions. The economic cost of DKD will grow to prohibitive amounts unless strategies to prevent its onset or progression are urgently implemented. In type 1 and type 2 diabetes, the presence of microalbuminuria and macroalbuminuria confers increased risk of developing ESRD and of death. Comparison of recent studies with earlier historical studies shows that the incidence of ESRD and death has decreased in DKD. Increased risk of albuminuria has been identified in certain non-European ethnic groups. However, the initial concept of progression of DKD as an albuminuric phenotype involving development of microalbuminuria, macroalbuminuria, and then ESRD has had to be modified. Albumin excretion frequently regresses, and GFR can decline without abnormality in albumin excretion. There is emerging evidence that changes in renal function occurring early in the course of diabetes predict future outcomes. The major challenges are to prevent DKD onset, to detect it early, and to improve DKD outcomes globally.

Publication types

  • Review

MeSH terms

  • Albuminuria* / epidemiology
  • Albuminuria* / etiology
  • Albuminuria* / physiopathology
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Cost of Illness
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetes Mellitus, Type 1* / physiopathology
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / physiopathology
  • Diabetic Nephropathies* / epidemiology
  • Diabetic Nephropathies* / etiology
  • Diabetic Nephropathies* / physiopathology
  • Diabetic Nephropathies* / prevention & control
  • Diabetic Nephropathies* / urine
  • Disease Progression
  • Early Diagnosis
  • Early Medical Intervention
  • Epidemiologic Studies
  • Ethnic Groups
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / etiology
  • Kidney Failure, Chronic* / physiopathology
  • Kidney Failure, Chronic* / urine
  • Outcome Assessment, Health Care
  • Risk Factors
  • Survival Analysis