Kidney Functions decline more rapidly in diagnosed Diabetics

Rapid kidney function decline is found more in individuals with diagnosed diabetes than those without diabetes, according to a study published in the journal Diabetes Care. Those with diagnosed diabetes, the kidney function declined almost twice as rapidly as those without diabetes.

Bethany Warren and his associates conducted a study to characterize the long-term kidney disease trajectories in persons with and without diabetes in a general population.

The study classified 15,517 participants in the community-based Atherosclerosis Risk in Communities (ARIC) study by diabetes status at baseline (1987–1989; no diabetes, undiagnosed diabetes, and diagnosed diabetes). The researchers used linear mixed models with random intercepts and slopes to quantify estimated glomerular filtration rate (eGFR) trajectories at four visits over 26 years.

The study found that the adjusted mean eGFR decline over the full study period among participants without diabetes was −1.4 mL/min/1.73 m2/year; with undiagnosed diabetes was −1.8 mL/min/1.73 m2/year, and with diagnosed diabetes was −2.5 mL/min/1.73 m2/year. Among participants with diagnosed diabetes, risk factors for steeper eGFR decline included African American race, APOL1 high-risk genotype, systolic blood pressure ≥140 mmHg, insulin use, and higher HbA.

The study concluded among people with diagnosed diabetes, steeper declines were seen in those with modifiable risk factors, including hypertension and glycemic control, suggesting areas for continued targeting in kidney disease prevention.

Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease. In 2000, India (31.7 million) ranked first in the world with the highest number of people with diabetes mellitus. It is predicted that by 2030 diabetes mellitus may afflict up to 79.4 million individuals in India.