New research suggests that people with type 2 diabetes need to concentrate on keeping their kidneys healthy as a way to extend their life. The study conducted established that patients with type 2 diabetes and kidney disease are at an elevated risk for death.
Maryam Afkarian, MD, PhD, of the Kidney Research Institute and division of nephrology at the University of Washington in Seattle, said: "People with type 2 diabetes have many other risk factors for cardiovascular disease and mortality, so we expected that kidney disease would predict a part, but not a majority, of higher mortality associated with type 2 diabetes. To our surprise, we found that even in the medically complex patients with type 2 diabetes, kidney disease is a very powerful predictor of premature death."
One in every 10 Americans has diabetes, and over a third of those will develop kidney disease. It is possible to live a healthy and fulfilling life with diabetes, but once kidney disease is in the picture, the rate of mortality rises significantly.
People with diabetes already have an increased risk of dying early as well as an increased risk of developing kidney disease: Afkarian and her colleagues explored the link between these two risks.
The researchers analyzed mortality rates in 15,046 adults in the U.S. Kidney disease was present in 42.3 percent of participants with diabetes, and 9.4 percent of participants without diabetes.
- People without kidney disease or diabetes, the 10 year mortality was 7.7 percent
- People with diabetes but no kidney disease, mortality was 11.5 percent
- People with both diabetes and kidney disease, mortality was 31.1 percent
Afkarian added, "First, among people with type 2 diabetes, the subgroup with kidney disease carries most of the mortality risk, so targeting intensive risk factor modification on this subgroup is likely to have the highest impact on overall mortality of people with diabetes. Secondly, preventing kidney disease may be a powerful way of reducing mortality in people with diabetes."
A limitation of this study could be its observational nature, however, the authors suggest that patients with kidney disease and diabetes should be targeted for interventions and therapy to decrease risk for cardiovascular disease and death.
Michael Sachs, PhD, Bryan Kestenbaum, MD, MS, Irl Hirsch, MD, Katherine Tuttle, MD, FACP, FASN, Jonathan Himmelfarb, MD, and Ian de Boer, MD, MS. Journal of the American Society of Nephrology, January 24, 2013, doi: 10.1681/201207071