Researchers call for more screening for kidney disease in people with type 1 diabetes

by Barbara Hewitt on September 28, 2017

More screening for kidney disease in people with type 1 diabetes is needed, especially for older people, according to researchers.

Factors that can lead to kidney disease, such as high blood pressure and cholesterol, in type diabetics should be managed more intensively as a preventative measure, according to the research from the University of Pittsburgh in the in the United States.

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Their study shows that having type 1 diabetes for 50 years increases the risk of kidney disease, known as diabetic nephropathy, and although cases are falling, incidences of actual kidney failure are falling, incidences of microalbuminuria and macroalbuminuria are not.

‘We must, therefore, expand our focus to intensively manage kidney disease risk factors as well and encourage research projects aiming to identify currently unknown risk factors, since they may offer an additional opportunity to reduce the development of kidney disease,’ said lead author Tina Costacou, associate professor of epidemiology at the University of Pittsburgh.

The study looked at the cumulative risk over 50 years of kidney complications in a cohort of 932 people diagnosed with type 1 diabetes as children between 1950 and 1980. The cumulative incidence of microalbuminuria, macroalbuminuria, kidney disease and all-cause mortality increased with longer diabetes duration.

However, when comparing patients diagnosed after 1965 to those diagnosed between 1950 and 1965 a decline was observed in kidney disease rates and the study suggests this could be due to increased life expectancy among people with type 1 diabetes.

In the group the mean baseline age was 27 years, the mean diabetes duration was 19 years and mean age at which type 1 diabetes was diagnosed was eight years old.

The research also found that being diagnosed with type 1 diabetes before the age of six was associated with the lowest risk and incidence generally did not differ by sex.

Some degree of kidney disease in type 1 diabetes is virtually universal at long durations and not declining, which has major implications for health care and research strategies,’ Costacou explained in the study report.

‘It is, therefore, crucial that we are able to focus on prevention efforts and decrease the development of even early signs of kidney disease,’ Costacou added.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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