More than 1 in 10 veterans at earlier stages of diabetic kidney disease (DKD) progress to the next or higher stage within a year, investigators reported at the National Kidney Foundation’s 2023 Spring Clinical Meetings in Austin, Texas.

The findings highlight a critical period when interventions can be implemented to slow DKD progression, according to Joanne LaFleur, MD, of the University of Utah in Salt Lake City and colleagues. Unfortunately, few patients receive an early diagnosis.

During 2016 to March 2022, a total of 685,288 veterans were diagnosed with DKD based on their estimated glomerular filtration rate and urinary albumin to creatinine ratio or urinary protein to creatinine ratio. Most patients (79%) were diagnosed late, at DKD stages 3a or 3b. The investigators found that the prevalence of DKD was higher among US veterans than the general population.

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The 5-year cumulative incidence proportions of DKD progression or death were 52.0%, 47.4%, 50.5%, and 60.9% among veterans with stage G1, G2, G3a, and G3b DKD, respectively, Dr LaFleur’s team reported.

Diabetic kidney disease may progress rapidly among veterans due to their high comorbidity burden. On average, veterans with DKD were in the overweight or class 1 obese categories of body mass index. Dyslipidemia affected approximately half and hypertension approximately two-thirds of veterans across DKD stages.

“In March 2020, the Veterans Health Administration Directive 1053 established a policy to improve prevention, early recognition and management of CKD in VHA medical facilities,” Dr LaFleur’s team wrote. “In accordance with the goals of VHA Directive 1053, earlier identification of those at high risk of DKD progression and death will help minimize the overall DKD burden in the VHA.”

Disclosure: This research was supported by Renalytix AI. Please see the original reference for a full list of disclosures.


Kim K, Crook J, Lu CC, Nyman H, LaFleur J. Diabetic kidney disease epidemiology in US veterans. Presented at: NKF 2023, Austin, Texas, April 11-15. Abstract 268.