Increased Prevalence of Diabetic Kidney Disease

Increase proportional to diabetes prevalence, despite increased use of diabetes medications

WEDNESDAY, June 22 (HealthDay News) -- The prevalence of diabetic kidney disease (DKD) in the United States increased between 1988 and 2008 in proportion to the prevalence of diabetes, according to a study published online June 22/29 in the Journal of the American Medical Association.

Ian H. de Boer, M.D., from the University of Washington in Seattle, and colleagues examined temporal changes in DKD prevalence in the United States using data from the National Health and Nutrition Examination Surveys (NHANES) from 1988 to 1994 (NHANES III), 1999 to 2004, and 2005 to 2008. Participants with diabetes were defined by hemoglobin A1c levels, use of glucose-lowering medications, or both. DKD was defined as diabetes with albuminuria, impaired glomerular filtration rate (GFR), or both. Albuminuria prevalence was adjusted to estimate persistent albuminuria.

The investigators found that the prevalence of DKD increased significantly, from 2.2 percent in NHANES III to 2.8 percent in NHANES 1999 to 2004 and 3.3 percent in NHANES 2005 to 2008. DKD prevalence increased in direct proportion to the prevalence of diabetes, with no change in DKD prevalence among individuals with diabetes. From NHANES III to NHANES 2005 to 2008, there was a significant increase in the use of glucose-lowering medications in individuals with diabetes (56.2 to 74.2 percent) and in the use of renin-angiotensin-aldosterone system inhibitors (11.2 to 40.6 percent). During the same time period, the prevalence of impaired GFR increased significantly, from 14.9 to 17.7 percent (P = 0.03), and albuminuria prevalence decreased slightly, from 27.3 to 23.7 percent (P = 0.7).

"Among persons with diabetes, prevalence of DKD was stable despite increased use of glucose-lowering medications and renin-angiotensin-aldosterone system inhibitors," the authors write.

One of the study authors disclosed financial relationships with the pharmaceutical and biotechnology industries.

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