Chronic Kidney Disease More Common in Type 2 Diabetes Than in Type 1 Diabetes

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NHANES data from 2009 to 2014 suggests that 25% of adults within the United States with diabetes have chronic kidney disease.
NHANES data from 2009 to 2014 suggests that 25% of adults within the United States with diabetes have chronic kidney disease.
The following article is part of conference coverage from the American Diabetes Association's 78th Scientific Sessions (ADA 2018) in Orlando,Florida. Endocrinology Advisor's staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back for the latest news from ADA 2018.

ORLANDO – Chronic kidney disease (CKD) is more prevalent among adults with type 2 diabetes compared with adults with type 1 diabetes, according to results presented at the American Diabetes Association's 78th Scientific Sessions held in Orlando, Florida, June 22-26, 2018.

The results also indicated that, while uncommon, macroalbuminuria significantly predicted estimated glomerular filtration rate (eGFR) decline in those with both type 1 and type 2 diabetes.

The study included participants with type 1 diabetes (n=48,036) and type 2 diabetes (n=1,461,915) from a clinical laboratory database maintained by LabCorp®. The researchers calculated rates of eGFR decline for participants with ≥3 eGFR results over at least a 1-year period. They defined CKD as eGFR <60 mL.min/1.73 m2 or albumin-to-creatinine ratio ≥30 mg/g.

The results showed that participants with type 2 diabetes had a higher prevalence of CKD compared with participants with type 1 diabetes (44.3% vs 31.6%, P <.001). The proportion of participants who were classified as high or very high risk for CKD was also higher among those with type 2 diabetes (17.8% vs 12.0%, P <.001).

Macroalbuminuria, defined as an albumin-to-creatinine ratio >300, was not prevalent in either group, occurring in 7.8% of participants with type 1 diabetes and in 8.3% of participants with type 2 diabetes.

Whereas median eGFR decline (mL/min/year) was low in the overall population (-0.6 for type 1 diabetes; -0.8 for type 2 diabetes), it was high for participants with macroalbuminuria, with median annual rates of decline of -3.80 for type 1 and -3.58 for type 2 diabetes.

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Reference

Cressman M, Ennis JL, Goldstein BJ, et al. CKD prevalence and risk are higher in adults with type 2 vs. type 1 diabetes — an assessment of 1.5 million patients recently evaluated in U.S. clinical practices. Presented at: ADA 2018 78th Scientific Sessions; June 22-26, 2018; Orlando, FL. Poster 544.

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