Diabetic nephropathy epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3]
Overview
The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in the incidence of type 2 diabetes.
In the United States, prevalence of Diabetes Nephropathy had increased from 7.4% to 9.6% within a 10 years period (1988 to 2008), and this trend will likely continue due to the increasing incidence of diabetes in the American populace [1]. Studies by de Boer et al showed that DN accounts for 44% of new ESRD cases with 6% attributed to type 1 DM, 38% attributed to type 2 DM, and a projected increase of 3 million cases over the course of 20 years[1]. This increased incidence and prevalence of DN is notably greater among African Americans, Asians, and Native Americans than it is among Caucasians. Risk factors for DN include poor glycemic control, hypertension, tobacco use, and early age of onset of Diabetes Mellitus.
Diabetic nephropathy (DN) is the most common cause of end-stage-renal-disease (ESRD) and most common cause for dialysis in the Western world, accounting for approximately 30-45% of all cases of ESRD. Blacks, Hispanics, and Native Americans are at increased risk of developing DN. Advanced age in type II diabetes and diagnosis at younger age in type I diabetes are significantly associated with DN. There seems to be a familial predisposition to DN.
Epidemiology and Demographics
Diabetic nephropathy is the most common etiology of nephropathy and dialysis in the Western world.[2] It accounts for approximately 30-45% of all causes of end-stage renal disease (ESRD).[3][4] The incidence of albuminuria is currently estimated to be as high as 0.83% annually.[3] Almost 39% of patients with diabetes mellitus have positive microalbuminuria.[5] Unfortunately, the worldwide burden of diabetic nephropathy seems to be on the rise, with an incidence rising by 150% per one decade in USA, Europe, and Japan and a prevalence increasing from 6.4% in 2010 and estimated to reach 7.7% in 2030.[6][7] Costs due to diabetic nephropathy reach as high as 30-40 billion USD annually in the USA only.[8][9]
The burden of diabetic nephropathy from type II diabetes is far more significant than that of type I diabetes.[10] Advanced age in type 2 diabetes and early diagnosis in type 1 diabetes are associated with higher risk of DN.[11][12] Gender does not seem to play a role in the risk of DN. Blacks, Hispanics, and Native Americans are at increased incidence and severity of diabetic nephropathy and are more likely to suffer ESRD, even when adjusting for other associated risk factors, such as hypertension and socioeconomic status.
DN seems to have a familial predisposition. Diabetic siblings of patients with DN have an increased risk of DN up to 3-times as those of patients without DN.[13] In one study evaluating familial predisposition of DN in Pima Indian families, the likelihood of developing proteinuria in patients with type 2 diabetes increased significantly when one or both parents have proteinuria.[14] Several genes have shown to have an important role in the development of DN:
- Homozygous Z-2 allelle of aldose reductase gene[18]
- Beta subunit of G protein at position 825 allele[19]
References
- ↑ 1.0 1.1 de Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmelfarb J (2011). "Temporal trends in the prevalence of diabetic kidney disease in the United States". JAMA. 305 (24): 2532–9. doi:10.1001/jama.2011.861. PMC 3731378. PMID 21693741.
- ↑ Gray SP, Cooper ME (2011). "Diabetic nephropathy in 2010: Alleviating the burden of diabetic nephropathy". Nat Rev Nephrol. 7 (2): 71–3. doi:10.1038/nrneph.2010.176. PMID 21278716.
- ↑ 3.0 3.1 Reutens AT, Atkins RC (2011). "Epidemiology of diabetic nephropathy". Contrib Nephrol. 170: 1–7. doi:10.1159/000324934. PMID 21659752.
- ↑ Kurokawa K, Nangaku M, Saito A, Inagi R, Miyata T (2002). "Current issues and future perspectives of chronic renal failure". J Am Soc Nephrol. 13 Suppl 1: S3–6. PMID 11792755.
- ↑ Rossing P (2006). "Diabetic nephropathy: worldwide epidemic and effects of current treatment on natural history". Curr Diab Rep. 6 (6): 479–83. PMID 17118233.
- ↑ Shaw JE, Sicree RA, Zimmet PZ (2010). "Global estimates of the prevalence of diabetes for 2010 and 2030". Diabetes Res Clin Pract. 87 (1): 4–14. doi:10.1016/j.diabres.2009.10.007. PMID 19896746.
- ↑ Mallick NP, Jones E, Selwood N (1995). "The European (European Dialysis and Transplantation Association-European Renal Association) Registry". Am J Kidney Dis. 25 (1): 176–87. PMID 7810523.
- ↑ Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K; et al. (2012). "'United States Renal Data System 2011 Annual Data Report: Atlas of chronic kidney disease & end-stage renal disease in the United States". Am J Kidney Dis. 59 (1 Suppl 1): A7, e1–420. doi:10.1053/j.ajkd.2011.11.015. PMID 22177944.
- ↑ Trivedi HS, Pang MM, Campbell A, Saab P (2002). "Slowing the progression of chronic renal failure: economic benefits and patients' perspectives". Am J Kidney Dis. 39 (4): 721–9. doi:10.1053/ajkd.2002.31990. PMID 11920337.
- ↑ Zimmet P, Alberti KG, Shaw J (2001). "Global and societal implications of the diabetes epidemic". Nature. 414 (6865): 782–7. doi:10.1038/414782a. PMID 11742409.
- ↑ Gall MA, Hougaard P, Borch-Johnsen K, Parving HH (1997). "Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study". BMJ. 314 (7083): 783–8. PMC 2126209. PMID 9080995.
- ↑ Klein R, Klein BE, Moss SE, Cruickshanks KJ, Brazy PC (1999). "The 10-year incidence of renal insufficiency in people with type 1 diabetes". Diabetes Care. 22 (5): 743–51. PMID 10332675.
- ↑ Ayodele OE, Alebiosu CO, Salako BL (2004). "Diabetic nephropathy--a review of the natural history, burden, risk factors and treatment". J Natl Med Assoc. 96 (11): 1445–54. PMC 2568593. PMID 15586648.
- ↑ Pettitt DJ, Saad MF, Bennett PH, Nelson RG, Knowler WC (1990). "Familial predisposition to renal disease in two generations of Pima Indians with type 2 (non-insulin-dependent) diabetes mellitus". Diabetologia. 33 (7): 438–43. PMID 2401399.
- ↑ Jeffers BW, Estacio RO, Raynolds MV, Schrier RW (1997). "Angiotensin-converting enzyme gene polymorphism in non-insulin dependent diabetes mellitus and its relationship with diabetic nephropathy". Kidney Int. 52 (2): 473–7. PMID 9264004.
- ↑ Kuramoto N, Iizuka T, Ito H, Yagui K, Omura M, Nozaki O; et al. (1999). "Effect of ACE gene on diabetic nephropathy in NIDDM patients with insulin resistance". Am J Kidney Dis. 33 (2): 276–81. PMID 10023638.
- ↑ Kunz R, Bork JP, Fritsche L, Ringel J, Sharma AM (1998). "Association between the angiotensin-converting enzyme-insertion/deletion polymorphism and diabetic nephropathy: a methodologic appraisal and systematic review". J Am Soc Nephrol. 9 (9): 1653–63. PMID 9727374.
- ↑ Shah VO, Scavini M, Nikolic J, Sun Y, Vai S, Griffith JK; et al. (1998). "Z-2 microsatellite allele is linked to increased expression of the aldose reductase gene in diabetic nephropathy". J Clin Endocrinol Metab. 83 (8): 2886–91. doi:10.1210/jcem.83.8.5028. PMID 9709964.
- ↑ Blüthner M, Schmidt S, Siffert W, Knigge H, Nawroth P, Ritz E (1999). "Increased frequency of G-protein beta 3-subunit 825 T allele in dialyzed patients with type 2 diabetes". Kidney Int. 55 (4): 1247–50. doi:10.1046/j.1523-1755.1999.00399.x. PMID 10200987.