Diabetes and Kidney Failure: A New Tool to Break the Cycle

New York, NY
February 7, 2007

Untitled Document

The National Kidney Foundation’s Kidney Disease Outcome Quality Initiative (KDOQI, www.kdoqi.org) released this month in the American Journal of Kidney Diseases the first comprehensive guidelines on chronic kidney disease (CKD) and diabetes.

“The guidelines emphasize diabetes prevention as well as screening and management of kidney disease and unveil a new term -- diabetic kidney disease or DKD -- which refers to the structural changes in the kidney that are specific to diabetes and can be detected by noninvasive tests, without the need for a biopsy,” said Dr. Rob Nelson, KDOQI work group co-chair and staff clinician at the National Institute of Diabetes and Digestive Kidney Diseases in Phoenix, Arizona.

“Practitioners from around the globe who manage diabetes and CKD patients will read these guidelines not only for information but for insight on the diabetes epidemic they are facing,” said NKF president Dr. Allan Collins. The incidence of diabetes is expected to double between 2000 and 2030 an estimated 21 million people in the US have diabetes and over half of those people have kidney damage or disease.

The guidelines affirm the American Diabetes Association (ADA) and other professional societies’ screening recommendations of annual testing of diabetic patients, while highlighting the need for microalbuminuria detection. Screening should include measurements of urinary albumin-to-creatinine ratio (ACR) in a spot urine sample and measurement of serum creatinine to estimate the glomerular filtration rate (GFR).

All patients with diabetes should be screened for DKD because treatments that slow or prevent the disease and its complications are available. These treatments include:

  • Intensive glycemic control
  • Antihypertensive therapies
  • Cholesterol lowering
  • Dietary protein restriction.

“Strict glycemic control is key in preventing DKD and delaying progression to kidney failure,” said KDOQI work group co-chair Dr. Katherine Tuttle of the Medical and Scientific Director of Research at Providence Medical Research Center in Spokane, Washington.

When it comes to nutrition, patients with diabetes and CKD should:

  • Consume enough protein, but avoid overindulgence.
  • Choose vegetable or soy protein sources.
  • Follow United States Department of Agriculture’s recommended daily allowance of protein as a useful, healthy guide.
  • Strive for a normal body mass index (BMI). BMI is calculated from your height and weight. BMI is an objective indicator if a person is overweight, underweight or at a healthy weight.

Guideline Work Group
The NKF- KDOQI Clinical Practice Guidelines for Diabetes and CKD Disease are the product of three years of reviewing evidence published in peer-reviewed medical journals and the dedication of 16 volunteer experts in nephrology, endocrinology, epidemiology, nutrition, cardiology, nursing, internal medicine and pharmacology. As with all KDOQI Guidelines, the document was widely distributed for a public/ peer review prior to finalizing. The National Kidney Foundation gratefully acknowledges the support of Amgen and Keryx which made development of these guidelines possible.

About the National Kidney Foundation

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well being of individuals and families affected by these diseases, influencing public policy in support of the kidney community and increasing the availability of all organs for transplantation.

To order the guideline, please call 800-622-9010, 212-889-2210 or visit www.kidney.org