March is National Kidney Month, making it a good time to remind ourselves about the risks of kidney disease for people with diabetes. In fact, diabetes is the most common single cause of end-stage kidney disease in the US and Europe. Other facts:

• Diabetic nephropathy now accounts for about 40 percent of new cases of end-stage kidney disease.
• About 20 to 30 percent of people with type 1 or type 2 diabetes develop evidence of nephropathy.
• In type 2 diabetes, a smaller fraction of the above progress to end-stage disease.
• People with diabetes and kidney disease account for over half of all patients starting on kidney dialysis.

In its new Position Statement on Diabetic Nephropathy, the American Diabetes Association (ADA) notes that early intervention has proven successful in reducing the onset and the course of nephropathy. Therefore, anyone diagnosed with type 2 diabetes should be tested for the early signs of kidney disease, microalbuminuria, or the presence of albumin in the urine, at the time of diagnosis and yearly thereafter. This annual screening should be done in patients with type 1 diabetes after they have had the disease for five years.

The Position Statement also notes that controlling blood glucose and blood pressure reduces the risk and/or slows the progression of kidney disease. To control blood pressure in people with diabetes and early signs of kidney disease, those with type 1 diabetes should receive ACE inhibitors while those with type 2 diabetes should be given angiotensin receptor blockers (ARBs), according to the ADA guidelines.

Related information Complications - Kidney

Source:  ADA. Diabetic nephropathy - a position statement. Diabetes Care, January 2002;25(Suppl 1):S85-S89.