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Kidney disease increased risk for mortality in type 2 diabetes
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The role of kidney disease in patients with type 2 diabetes has not been studied at length, according to researchers. However, new data from the Third National Health and Nutrition Examination Survey, published in the Journal of the American Society of Nephrology, suggest that patients with type 2 diabetes and kidney disease are at an increased risk for mortality.
“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,” Maryam Afkarian, MD, PhD, of the Kidney Research Institute and division of nephrology at the University of Washington in Seattle, said in a press release.
Afkarian and colleagues examined the 10-year cumulative mortality rates by diabetes and kidney disease status in 15,046 participants in NHANES III. Of the patients included, 9.5% had type 2 diabetes. Of those, 42.3% had kidney disease, as defined by albuminuria, impaired glomerular filtration rate (GFR) or both. Conversely, 9.4% of patients without diabetes had kidney disease.
According to data, those without diabetes or kidney disease had a 10-year mortality rate of 7.7% (95% CI, 7-8.3) vs. 11.5% for patients with diabetes but without kidney disease (95% CI, 7.9-15.2). Those with diabetes and kidney disease demonstrated a mortality rate of 31.1% (95% CI, 24.7-37.5), researchers wrote.
Afkarian said the findings have important implications.
“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,” Afkarian said. “Secondly, preventing kidney disease may be a powerful way of reducing mortality in people with diabetes.”
Although the major limitation is the study’s observational nature, Afkarian and colleagues wrote that patients with diabetes and kidney disease should be targeted for therapeutic interventions designed to reduce risk for CVD and mortality.
Disclosure: The researchers report no relevant financial disclosures.
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