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Kidney disease a key source of risk in diabetics

Saturday January 26, 2013
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Although patients with diabetes have a chance to live a long and healthy life, their risk of dying prematurely increases significantly if they develop kidney disease, according to a study.

The researchers said the findings have significant clinical implications for the prevention and treatment of kidney disease in people with diabetes.

Maryam Afkarian, MD, PhD, of the University of Washington and her colleagues investigated the extent to which kidney disease contributes to diabeticsí increased risk of dying early. The researchers examined 10-year mortality rates in 15,046 adults in the United States. Kidney disease was present in 9.4% and 42.3% of individuals without and with type 2 diabetes, respectively.

Among people without diabetes or kidney disease, 10-year mortality was 7.7%. It rose to 11.5% in those with diabetes but without kidney disease, and to 31.1% in those with both diabetes and kidney disease.

"People with type 2 diabetes have many other risk factors for cardiovascular disease and mortality, so we expected that kidney disease would predict a part, but not a majority, of higher mortality associated with type 2 diabetes," Afkarian said in a news release. "To our surprise, we found that even in the medically complex patients with type 2 diabetes, kidney disease is a very powerful predictor of premature death."

Afkarian noted the findings have important implications: "First, among people with type 2 diabetes, the subgroup with kidney disease carries most of the mortality risk, so targeting intensive risk factor modification on this subgroup is likely to have the highest impact on overall mortality of people with diabetes. Secondly, preventing kidney disease may be a powerful way of reducing mortality in people with diabetes."

The study is scheduled for publication in the Journal of the American Society of Nephrology.


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