Three Factors Are Key to Kidney Risk in Type 2 Diabetes

Patients with diabetes and suffering from acute kidney injury (AKI), proteinuria and uncontrolled blood sugar experience a sharp reduction in the number of years they have healthy renal function before being forced onto dialysis, according to researchers at the University of Cincinnati (UC) College of Medicine. The UC research team looked at 3,679 individuals with type 2 diabetes from a de-identified cohort of patients at the Cincinnati Veterans Affairs Medical Center and who were followed for a 10-year period, explains Charuhas Thakar, M.D., professor and Director of the UC Division of Nephrology, Kidney CARE Program. The three risk factors--AKI, proteinuria (leakage of protein into the urine) and poor blood sugar control--were used to classify patients into three groups, he says. Patients with diabetes who had none of these risk factors were compared against a group that had all three risk factors (severe risk) and another group that had only one or two of the risk factors (medium risk). "There are established risk factors in the diabetes literature," says Dr. Thakar. "One of them is the level of sugar control; if you don't control your sugar well your kidney disease progresses faster or if you leak protein in the urine and you have proteinuria, it tends to be an independent predictor of kidney disease in diabetics." Typically, a 50-year-old person with type 2 diabetes without any of the risk factors has kidney function of about 60 percent and is likely to lose renal function at around 1.9 to 2 percent annually, says Thakar. That means this individual would have 25 to 30 years before kidney failure forces the need for dialysis allowing the patient to have normal renal function up to age 80.
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