More than 20% of US adults with type 1 diabetes likely have chronic kidney disease
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Key takeaways:
- Of a small group of 47 adults with type 1 diabetes in NHANES, 20 met the criteria for having CKD.
- Researchers said increased CKD surveillance and treatment strategies are needed in type 1 diabetes.
More than one in five adults in the U.S. with type 1 diabetes also have chronic kidney disease, according to findings from a brief report published in Diabetes Care.
In a cross-sectional analysis, researchers used National Health and Nutrition Examination Survey data to estimate the prevalence of CKD among adults with type 1 diabetes. The study estimated 258,196 adults in the U.S. have both type 1 diabetes and CKD, and the researchers said the real-world prevalence could be higher because the study excluded some groups.
“We need to focus on identification, prevention and treatment of [renal] complications in type 1 diabetes,” Peter Rossing, MD, DMSc, head of complications research at Steno Diabetes Center in Copenhagen, Denmark, and professor in diabetic angiopathy at University of Copenhagen, told Healio. “We have focused a lot on type 2 diabetes, maybe some of the drugs working there can also be used in type 1 diabetes.”
Researchers obtained NHANES data from the 2015-2016 and 2017-2018 cycles. A treatment-based algorithm was used to identify adults with type 1 diabetes and CKD. Adults were defined as having type 1 diabetes if they used insulin therapy as their only antihyperglycemic medication and started insulin within 1 year of type 1 diabetes diagnosis. Adults with type 1 diabetes who had an estimated glomerular filtration rate of 60 mL/min/1.73 m2 or less or a urinary albumin-to-creatinine ratio of 30 mg/g or higher were defined as having CKD. Sample weighting was used to estimate the prevalence of CKD among adults with type 1 diabetes in the U.S.
There were 54 adults identified as having type 1 diabetes among 19,225 adults in NHANES. Of 47 adults with type 1 diabetes who had eGFR and albumin-to-creatinine ratio data available, 20 had CKD.
The weighted number of adults with type 1 diabetes in NHANES corresponded to an estimated 1,281,913 adults with type 1 diabetes in the U.S. population. Of that group, an estimated 258,196 adults had both CKD and type 1 diabetes. The weighted prevalence of CKD among adults with type 1 diabetes was 21.5%. Adults with CKD and type 1 diabetes had a mean eGFR of 57 mL/min/1.73 m2 and a median urinary albumin-to-creatinine ratio of 89 mg/g.
Rossing said the prevalence found in the study is similar to what has been reported in larger groups in Europe, though studies including larger groups people with type 1 diabetes are needed to confirm the findings.
“Data to support the prevalence on larger cohorts is needed,” Rossing said. “Intervention studies, such as testing if SGLT2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists and GLP-1 receptor agonists, could play a role here as well.”
For more information:
Peter Rossing, MD, DMSc, can be reached at peter.rossing@regionh.dk.
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