Call for Prevention and Proper Management of Diabetic Kidney Disease
Subgroup: Volume 7, Issue 3, Summer
Date: September 2009
Start Page: 160
End Page: 161
- Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR.Iran
City, Province: Tehran,
E-mail: e-mail: email@example.com
The increase in the prevalence of diab-etes mellitus is greater in developing than developed countries.1 While the prevalence of type 2 diabetes has doubled in developed countries, it has had a 3-5 fold increase in China, Indonesia, India, Thailand and Korea.2 The Tehran Lipid and Glucose Study, a population based study conducted in the capital city of Iran, a country in nutrition transition, documented a 1% yearly rise in the prevalence of type 2 diabetes in recent years.3
Despite the diabetes epidemic this century, the remarkable lack of awareness among pop-ulations about diabetes continues,4 with almost half of these diabetic individuals being unaware of their condition.5 The combination of the increasing prevalence of diabetes and the unawareness of the disease is accompanied by a rise in the serious complications of diabetes, in particular in the developing countries, where strategies for prevention, screening and mana-gement strategies are inadequate.
One of the major complications of diabetes is diabetic kidney disease. Diabetes is the major cause, of approximately 20-40% of end stage renal zfailure worldwide.6 During a 15-year follow-up, 40% of type 2 diabetics developed microalbuminuria8 and there is a 2-3% rate of development of kidney failure in newly diag-nosed type 2 diabetes with normal kidney function.9 It is of interest that the risk of met-abolic syndrome for developing chronic kidney disease escalates in the presence of diabetes and hypertension.10 Diabetic nephropathy-related albuminura and reduced glomerular filt-ration rate are independent risk factors for cardiovascular events and death11 and moderate chronic kidney disease is a major risk factor for development of ischemic heart disease.12 There-fore, early detection of diabetic kidney disease and aggressive coronary heart disease risk mod-ification in patients with moderate chronic kidney disease is urgently warranted.
The International Diabetes Federation toge-ther with the International Society of Nephro-logy and the International Federation of Kidney Foundations have proclaimed “World Kidney Day”, celebrated since 2006 on the second Thursday of March each year; the 2010 global campaign, while focusing on diabetes, high-lights the importance of diabetic kidney disease and underscores worldwide action for preven-tion of type 2 diabetes through massive lifestyle changes to raise patient awareness regarding diabetes and its complications, in particular kidney disease. It also recommends increased screening for early diabetic kidney disease, and emphasizes treatment strategies and promote research for development of new therapies.13
Diabetic kidney disease, although a global problem, requires mobilized action at the local level. Mass education, increasing awareness of those at risk of developing diabetes, screening, education and management of diabetic patients all involve not only the ministry of health of each country, but many governmental and non-governmental organizations, which must prio-ritize the issue as a health strategy for years to come. It is time to act and to act urgently.
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- Yoon KH, Lee JH, Kim JW, Cho JH, ChoiYH, Ko SH, et al. Epidemic obesity and type2 diabetes in Asia. Lancet 2006; 368: 1681-8.
- Harati H, Hadaegh F, Saadat N, Azizi F.Population-based incidence of type 2 diabetesand its associated risk factors: results from asix-year cohort study in Iran. BMC PublicHealth 2009; 9: 186.
- Dunstan DW, Zimmet PZ, Welborn TA, DeCourten MP, Cameron AJ, Sicree RA, et al.The rising prevalence of diabetes and impairedglucose tolerance: the Australian Diabetes,Obesity and Lifestyle Study. DiabetesCare 2002; 25: 829-34.
- Azizi F, Guoya MM, Vazirian P, Dolatshati P,Habbibian S. Screening for type 2 diabetes inthe Iranian national programme: a preliminaryreport. East Mediterr Health J 2003; 9:1122-7.
- National Institutes of Health, National Institute of Diabetes and Digestive and KidneyDiseases. International comparisons, in 2007Annual Data Report: Atlas of Chronic kidneyDisease and End-Stage Renal Disease in theUnited States. 2007, National Institutes ofHealth, National Institute of Diabetes and Digestiveand Kidney Diseases. Bethesda. P.239-54.
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- Parving HH, Lewis JB, Ravid M, Remuzzi G,Hunsicker LG; DEMAND investigators. Prevalenceand risk factors for microalbuminuriain a referred cohort of type II diabetic patients:a global perspective. Kidney Int 2006;69: 2057-63.
- Rashidi A, Ghanbarian A, Azizi F. Are patientswho have metabolic syndrome withourdiabetes at risk for developing chronic kidneydisease? Evidence based on data from a largecohort screening population. Clin J Am SocNephrol 2007; 2: 976-83.
- Ninomiya T, Perkovic V, de Galan BE,Zoungas S, Pillai A, Jardine M, et al; AdvanceCollaborative Group. Albuminuria andkidney function independently predict cardiovascularand renal outcomes in diabetes. JAm Soc Nephrol 2009; 20: 1813-21.
- Rashidi A, Ghanbarian A, Azizi F, Adler DS.Is chronic kidney disease comparable to diabetesas a coronary artery diseae risk factor?South Med J 2007; 100: 20-6.
- Atkins RC, Zimmet P. Diabetic kidney disease:Act now or pay later. Iran J Kidney Dis2010; 4: 9-12.