Diabetes and Chronic Kidney Disease

Diabetes is the leading cause of kidney failure, accounting for 44% percent of the new cases. Current research suggests that control of high blood pressure is a key factor in slowing this disease. Strict control of blood sugar levels and reduction of dietary protein intake are also important. Treatment to prevent diabetic kidney disease should begin early — before kidney damage develops.

• In the United States, 25.8 million people have diabetes. Of these, 18.8 million are diagnosed and nearly 7 million are undiagnosed.
• In 2010, diabetes led to more than 51,000 new cases of kidney failure and over 224,000 people are currently living with kidney failure resulting from diabetes.
• Diabetes is characterized by high levels of blood sugar, resulting from insufficient production of insulin or defects in insulin action in the body. Type 2 diabetes (also called noninsulin-dependent diabetes) is far more common than type 1 (insulin-dependent diabetes), accounting for about 90 to 95 percent of the cases of diabetes. Type 2 diabetes is most common in people over 40, but is increasing among younger people including children and adolescents.
• Diabetes damages small blood vessels throughout the body, affecting the kidneys as well as other organs and tissues including skin, nerves, muscles, intestines and the heart. Patients with diabetes can develop high blood pressure as well as rapid hardening of the arteries, which can also lead to heart disease and eye disorders.
• Diabetes is more prevalent in certain ethnic groups. In American adults aged 20 or older, diabetes has been diagnosed in 12.6% of non-Hispanic blacks, 11.8% of Hispanics, 8.4% of Asian Americans and 7.1% of non-Hispanic whites.
• The risk factors for type 1 diabetes include autoimmune, genetic and environmental factors. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes (diabetes during pregnancy), impaired glucose tolerance, physical inactivity and race or ethnicity.
• Research suggests high blood pressure may be the most important predictor for diabetics developing chronic kidney disease. Specific high blood pressure medications such as angiotensin converting enzyme (ACE) inhibitors and the angiotensin-2 receptor blockers (ARBs) may be the most effective in preventing diabetic kidney disease. It is important for diabetics to keep their blood pressure lower than 130/80.
• Some of the signs that diabetics may be developing chronic kidney disease include protein in the urine, high blood pressure, leg swelling or cramps, increased need to urinate (especially at night), abnormal blood tests (glomerular filtration rate, GFR), less need for insulin or anti-diabetic pills, nausea and vomiting, weakness, pallor and anemia, itching and diabetic eye disease.
• Treatment for diabetic kidney disease includes controlling blood pressure and blood sugar levels, reducing dietary protein intake, avoiding medications that may damage the kidneys, treating urinary tract infections and exercise and weight loss (under the supervision of a physician).
• More than 35% of people aged 20 years or older with diabetes have chronic kidney disease.
• If current trends continue, it is estimated that 1 in 3 U.S. adults will have diabetes in the year 2050 compared to 1 in 10 today.

Sources of Facts and Statistics:
United States Renal Data System, Centers for Disease Control and Prevention, National Institute of Diabetes and Digestive and Kidney Diseases, National Diabetes Education Program