Most Type 1 Diabetes Patients Have Kidney Disease

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Incidence of end-stage renal disease has declined but affects substantial portion of long-term T1D patients.
Incidence of end-stage renal disease has declined but affects substantial portion of long-term T1D patients.

(HealthDay News) -- Most patients with type 1 diabetes (T1D) of long duration have some degree of kidney disease, according to a study published online in Diabetes Care.

Tina Costacou, PhD, and Trevor J. Orchard, MD, from the University of Pittsburgh examined the 50-year cumulative kidney complication risk in 932 participants from a childhood-onset T1D cohort diagnosed during 1950 to 1980. Overall, 144 participants died before baseline (1986 to 1988), 130 were followed with periodic surveys, and 658 were followed with biennial surveys.

The researchers found that end-stage renal disease (ESRD) affected 60% of the cohort by 50 years of T1D duration, while macroalbuminuria and microalbuminuria affected 72 and 88%, respectively. In recent cohorts there was little evidence for declines in cumulative incidence, except for ESRD, which had a 45% decrease by 40 years of T1D duration, while microalbuminuria increased 3% and macroalbuminuria did not change. The lowest risk was seen for onset before age 6 years, and there was usually no difference in incidence by sex.

"Some degree of kidney disease in T1D is virtually universal at long durations and not declining, which has major implications for health care and research strategies," the authors write.

Reference

Costacou T and Orchard TJ. Cumulative Kidney Complication Risk by 50 Years of Type 1 Diabetes: The Effects of Sex, Age, and Calendar Year at Onset. Diab Care 2017 Oct; dc171118. doi: 10.2337/dc17-1118

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