According to a study, researchers analyzed that patients with diabetes are at risk for kidney disease. But the new research shows that patients could be suffering undiagnosed kidney damage even before they are aware that they have diabetes. Patients who will be diagnosed later with diabetes show signs of chronic kidney disease (CKD) also before their diabetes diagnosis. The study was published in the journal PLoS One.
The researchers found that more than 30% of diabetic veterans had prior CKD signs. They also found racial and regional disparities in kidney disease risk. About 10% of the U.S. population–around 20 million people–has CKD. Diabetes is the leading cause of CKD and end-stage renal disease. One-third of adults with diabetes have CKD.
Other conditions that often co-occur with diabetes, such as cardiovascular disease, also raise the risk of kidney disease. Early recognition of CKD can help implement measures that can delay its progression, and is thus very important. While there are no cures for established CKD, a healthy lifestyle, good blood pressure and diabetes control, and avoidance of various harmful exposures, such as over-the-counter painkillers, can help delay CKD's progression.
To assess the risk of kidney damage from undiagnosed diabetes, the researchers looked at data on 36,794 veterans who were diagnosed with diabetes between 2003 and 2013. They found that 31.6% of these veterans had evidence of CKD before the diabetes diagnosis, based on estimated glomerular filtration rate (eGFR) and urine-albumin-creatine ratios, two common measures of kidney function.
According to the researchers, the results highlight an opportunity for broadening screening among patients with increased risk of CKD. More screening of at-risk populations could lead to earlier identification of diabetes, which could, in turn, prevent organ damage. The disease also tends to progress faster in these populations.
But results in this study did not show a higher risk for Hispanics. More advanced kidney disease also had a more even racial distribution, according to the new data. The researchers posit that these differences could be because they were looking at a different stage of the disease. Most prior studies have focused on end-stage renal disease.
Authors conclude the highest rates of chronic kidney disease were in the upper Midwest, central and south Florida, and a band of the mid-south and North Carolina. These regional differences could be due to the lower socioeconomic status of veterans in those areas and less access to care. More analysis is needed to figure out exactly why these parts of the country have higher rates of CKD, as well as to explore the reasons for the difference in risk based on race.