Call for Prevention and Proper Management of Diabetic Kidney Disease

This Article


Article Information:

Group: 2009
Subgroup: Volume 7, Issue 3, Summer
Date: September 2009
Type: Editorial
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


      Affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences
      City, Province: Tehran,
      Country: IR.Iran
      E-mail: e-mail:

Manuscript Body:

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.

References: (13)

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