Diabetes-related kidney disease rates falling

The number of new cases of the most advanced form of kidney disease - end-stage renal disease - attributed to Diabetes mellitus (ESRD-DM) is declining among US women, whites, and persons below 65 years of age, according to U.S. surveillance data reported in the Morbidity and Mortality Weekly Report November 4th.

Although these surveillance data do not show the reasons for improvement, the authors posit that they may be due to "a reduction in the prevalence of cardiovascular disease risk factors such as high blood pressure and high cholesterol, improvements in diabetes care practices, or development of new pharmacologic agents to reduce the prevalence of kidney disease risk factors."

The decline in cases of kidney failure in some populations represents an encouraging trend in this serious complication of diabetes, health officials say. To continue improving this trend, persons with Diabetes or High Blood Pressure should talk to their doctor and get checked for kidney disease, they suggest.

End-stage renal disease is a condition in which the kidneys are no longer able to function normally. Usually this means that they are functioning at less than 10 percent of their normal capacity. When this occurs, dialysis or kidney transplant is needed.

In the United States, more than a third of people with end-stage renal disease have diabetes, and diabetic nephropathy (renal disease due to diabetes) is the leading cause of end-stage renal disease. Up to 40 percent of all people with type 1 (insulin-dependent or juvenile) diabetes eventually develop end-stage renal disease. Kidney disease also can develop in people with type 2 (non-insulin-dependent or adult-onset) diabetes. With either type, poor control of blood sugar increases the risk of end-stage renal disease.

Lead investigator Dr. N. R. Burrows and colleagues at the U.S. Centers for Disease Control and Prevention examined trends in ESRD-DM, using 1990-2002 data from the United States Renal Data System and the National Health Interview Survey.

The overall age-adjusted incidence increased from 247 to 305 per 100,000 persons with Diabetes between 1990 and1996, and then declined from 293 per 100,000 in 1997 to 232 per 100,000 in 2002.

In addition to the noted decreases in women, whites, and younger persons, the investigators found that the incidence between 1997 and 2002 remained steady among those between 65 and 74 years old, men, blacks and Hispanics, whereas the rate increased 10 percent for those age 75 and older.

SOURCE: Morbidity and Mortality Weekly Report, November 4, 2005.