Ten Facts About Diabetes and Chronic Kidney Disease

Diabetes is the leading cause of kidney failure in the United States. Because a cure for diabetic kidney disease has not yet been found, treatment involves controlling the disorder and slowing its progression to kidney failure. 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 also may be important. Treatment to prevent diabetic kidney disease should begin early – before kidney damage develops.

  1. In the U.S., 23.6 million people, or about 7.8 percent of the population, have diabetes. Of these, 17.9 million are diagnosed and 5.7 million (nearly one quarter) are undiagnosed. With 1.6 million new cases diagnosed annually, it is expected that by 2025, 8.9 percent of the U.S. population will have diabetes.1, 2
  2. Diabetes is characterized by high blood levels of 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.1 type 2 diabetes is most common in people over 40, but is increasing among younger people including children and adolescents. 1, 2
  3. Gestational diabetes affects about 4 percent of all pregnant women. This amounts to about 135,000 cases each year in the United States. It occurs more often among African Americans, Hispanic Americans and American Indians. It is also more common among women who are obese or have a family history of diabetes. Gestational diabetes, which occurs during pregnancy, should be treated to prevent complications in the infant. Women who have had gestational diabetes have a 20 to 50 percent chance of developing diabetes in the next 5 to 10 years.2
  4. Type 2 diabetes is more prevalent in certain ethnic groups. For example, 2.5 million, or 9.5 percent, of Hispanic Americans have diabetes. On average, Hispanic Americans are 1.7 times more likely to have diabetes than white Americans of similar age.  American Indians and Alaska Natives are about 2.2 times more likely to have diabetes than white Americans of similar age. Among American Indians and Alaska Natives receiving care from the Indian Health Service, 99,500,or 12.8 percent, have diabetes. About 3.2 million, or 13.3 percent, of African Americans have diabetes. They are 1.8 times more likely to have diabetes than white Americans of similar age. Asian and Pacific Islanders are also at increased risk for diabetes. For example, Native Hawaiians and other Pacific Islanders are more than twice as likely to have diabetes as whites of similar age.2
  5. Diabetes is the single leading cause of kidney failure in the U.S., accounting for about 44 percent of the people who start treatment for kidney failure each year, and about 38 percent of all Americans being treated for kidney failure. In 2003, diabetes accounted for nearly 44,000 new cases of kidney failure in the U.S. 2
  6. 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.2
  7. 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 lead to heart disease and eye disorders.4
  8. Researchers feel that the presence of high blood pressure may be the most important predictor of developing chronic kidney disease in diabetics. Therefore, the detection and control of high blood pressure are very important in diabetic patients. Specific high blood pressure medicines, such as the angiotensin converting enzyme (ACE) inhibitors and the angiotensin-2 receptor blockers (ARBs), may be the most effective in preventing diabetic kidney disease.  About 73 percent of adults with diabetes have blood pressure greater than 130/80 or use medications for high blood pressure.2
  9. Some of the signs that someone who has diabetes may be developing chronic kidney disease are:4
    • Protein in the urine
    • High blood pressure
    • Leg swelling, leg cramps
    • Increased need to urinate, especially at night
    • Abnormal blood tests, such as creatinine and estimated GFR tests
    • Less need for insulin or anti-diabetic pills
    • Morning sickness, nausea and vomiting
    • Weakness, pallor and anemia
    • Itching
  10. A cure for diabetic kidney disease has not yet been found; the treatment involves controlling the disorder and slowing its progression to irreversible kidney failure. Some of the treatments that may be effective are:3
    • Controlling high blood pressure to less than 130/80 mm/Hg 4
    • Controlling blood sugar levels
    • Reducing dietary protein intake
    • Avoiding medications that may damage the kidneys
    • Treating urinary tract infections
    • Exercise and weight loss (under the supervision of a physician)

Sources Facts and Statistics:

  1. “All About Diabetes” from The American Diabetes Association Home
  2. “Diabetes Statistics” from the National Kidney and Urologic Disease Information Clearinghouse (www.niddk.nih.gov)
  3. U.S. Renal Data System 2006 Annual Data Report (www.usrds.org)
  4. “Diabetes and Kidney Disease” from the National Kidney Foundation
  5. NKF-K/DOQI Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease.

September 2008

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