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{{Diabetic nephropathy}}
{{Diabetic nephropathy}}
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==Overview==
==Overview==
Diabetic nephropathy is one of the most common causes of [[chronic renal failure]] in the United States, responsible for 45 % of patients on [[dialysis]].
In the United States, prevalence of diabetic nephropathy (DN) has increased from 7.4% to 9.6% within a 20 years period (1988 to 2008), and this trend will likely continue due to the increasing incidence of diabetes in the American populace <ref name="pmid21693741">{{cite journal| author=de Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmelfarb J| title=Temporal trends in the prevalence of diabetic kidney disease in the United States. | journal=JAMA | year= 2011 | volume= 305 | issue= 24 | pages= 2532-9 | pmid=21693741 | doi=10.1001/jama.2011.861 | pmc=3731378 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21693741  }} </ref>. 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<ref name="pmid21693741">{{cite journal| author=de Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmelfarb J| title=Temporal trends in the prevalence of diabetic kidney disease in the United States. | journal=JAMA | year= 2011 | volume= 305 | issue= 24 | pages= 2532-9 | pmid=21693741 | doi=10.1001/jama.2011.861 | pmc=3731378 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21693741  }} </ref>. This increased incidence and prevalence of DN is notably greater among African Americans, Asians, and Native Americans than it is among Caucasians.
==Epidemiology and Demographics==


==Epidemiology and Demographics==
===Prevalence===
The syndrome can be seen in patients with [[chronic (medicine)|chronic]] [[diabetes]] (15 years or more after onset), so patients are usually of older age (between 50 and 70 years old). The disease is progressive and may cause [[death]] two or three years after the initial lesions, and is more frequent in men. Diabetic nephropathy is the most common cause of chronic kidney failure and end-stage kidney disease in the United States. People with both type 1 and type 2 diabetes are at risk. The risk is higher if blood-glucose levels are poorly controlled. Further, once nephropathy develops, the greatest rate of progression is seen in patients with poor control of their blood pressure. Also people with high cholesterol level in their blood have much more risk than others.
*It is estimated that half of the diabetic patients will develop diabetic nephropathy after 20 years of the onset of the disease.
*Diabetic nephropathy is the most common etiology of nephropathy and dialysis in the Western world.<ref name="pmid21278716">{{cite journal| author=Gray SP, Cooper ME| title=Diabetic nephropathy in 2010: Alleviating the burden of diabetic nephropathy. | journal=Nat Rev Nephrol | year= 2011 | volume= 7 | issue= 2 | pages= 71-3 | pmid=21278716 | doi=10.1038/nrneph.2010.176 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21278716  }} </ref>
* 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.<ref name="pmid19896746">{{cite journal| author=Shaw JE, Sicree RA, Zimmet PZ| title=Global estimates of the prevalence of diabetes for 2010 and 2030. | journal=Diabetes Res Clin Pract | year= 2010 | volume= 87 | issue= 1 | pages= 4-14 | pmid=19896746 | doi=10.1016/j.diabres.2009.10.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19896746  }} </ref><ref name="pmid7810523">{{cite journal| author=Mallick NP, Jones E, Selwood N| title=The European (European Dialysis and Transplantation Association-European Renal Association) Registry. | journal=Am J Kidney Dis | year= 1995 | volume= 25 | issue= 1 | pages= 176-87 | pmid=7810523 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7810523  }} </ref>
* Costs due to diabetic nephropathy reach as high as 30-40 billion USD annually in the USA only.<ref name="pmid22177944">{{cite journal| author=Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K et al.| title='United States Renal Data System 2011 Annual Data Report: Atlas of chronic kidney disease & end-stage renal disease in the United States. | journal=Am J Kidney Dis | year= 2012 | volume= 59 | issue= 1 Suppl 1 | pages= A7, e1-420 | pmid=22177944 | doi=10.1053/j.ajkd.2011.11.015 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22177944  }} </ref><ref name="pmid11920337">{{cite journal| author=Trivedi HS, Pang MM, Campbell A, Saab P| title=Slowing the progression of chronic renal failure: economic benefits and patients' perspectives. | journal=Am J Kidney Dis | year= 2002 | volume= 39 | issue= 4 | pages= 721-9 | pmid=11920337 | doi=10.1053/ajkd.2002.31990 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11920337  }} </ref>
* The burden of diabetic nephropathy from type II diabetes is far more significant than that of type I diabetes.<ref name="pmid11742409">{{cite journal| author=Zimmet P, Alberti KG, Shaw J| title=Global and societal implications of the diabetes epidemic. | journal=Nature | year= 2001 | volume= 414 | issue= 6865 | pages= 782-7 | pmid=11742409 | doi=10.1038/414782a | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11742409  }} </ref> 
* Advanced age in type 2 diabetes and early diagnosis in type 1 diabetes are associated with higher risk of DN.<ref name="pmid9080995">{{cite journal| author=Gall MA, Hougaard P, Borch-Johnsen K, Parving HH| title=Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study. | journal=BMJ | year= 1997 | volume= 314 | issue= 7083 | pages= 783-8 | pmid=9080995 | doi= | pmc=PMC2126209 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9080995  }} </ref><ref name="pmid10332675">{{cite journal| author=Klein R, Klein BE, Moss SE, Cruickshanks KJ, Brazy PC| title=The 10-year incidence of renal insufficiency in people with type 1 diabetes. | journal=Diabetes Care | year= 1999 | volume= 22 | issue= 5 | pages= 743-51 | pmid=10332675 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10332675  }} </ref> 
 
===Sex===
*Diabetic nephropathy has no sex predilection.
 
===Age===
*Most of the cases of diabetic nephropathy develop after 10 years of the diagnosis with most of the cases are diagnosed between 10 and 20 years after the onset of the disease.
*Diabetic nephropathy tends to occur in elderly patients with type 2 DM who have the disease for a long period of time.


==References==
==References==
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{{Reflist|2}}
{{Reflist|2}}


[[Category:Kidney diseases]]
[[Category:Pediatrics]]
[[Category:Angiology]]
[[Category:Endocrinology]]
[[Category:Diabetes]]
[[Category:Nephrology]]
 
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Latest revision as of 20:26, 13 June 2018

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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

In the United States, prevalence of diabetic nephropathy (DN) has increased from 7.4% to 9.6% within a 20 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.

Epidemiology and Demographics

Prevalence

  • It is estimated that half of the diabetic patients will develop diabetic nephropathy after 20 years of the onset of the disease.
  • Diabetic nephropathy is the most common etiology of nephropathy and dialysis in the Western world.[2]
  • 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.[3][4]
  • Costs due to diabetic nephropathy reach as high as 30-40 billion USD annually in the USA only.[5][6]
  • The burden of diabetic nephropathy from type II diabetes is far more significant than that of type I diabetes.[7]
  • Advanced age in type 2 diabetes and early diagnosis in type 1 diabetes are associated with higher risk of DN.[8][9]

Sex

  • Diabetic nephropathy has no sex predilection.

Age

  • Most of the cases of diabetic nephropathy develop after 10 years of the diagnosis with most of the cases are diagnosed between 10 and 20 years after the onset of the disease.
  • Diabetic nephropathy tends to occur in elderly patients with type 2 DM who have the disease for a long period of time.

References

  1. 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.
  2. 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. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.

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