More than four in 10 patients with diabetes have diabetic kidney disease (DKD), according to a study published online June 14 in BMJ Open Diabetes Research & Care.

Tomás P. Griffin, M.B., B.Ch., Ph.D., from Galway University Hospitals in Ireland, and colleagues assessed the prevalence of DKD and rapid renal function decline, as well as associated risk factors, among 4,606 adults attending a diabetes center in Northern Europe.

The researchers found that 42 percent of all diabetes patients had DKD, as did 23.4 percent with type 1 diabetes and 47.9 percent with type 2 diabetes. Rapid decline was more frequent with type 2 diabetes than with type 1 diabetes (32.8 versus 14 percent). Factors independently associated with rapid estimated glomerular filtration rate decline included older age, greater number of antihypertensive medications, higher log-normalized urine albumin to creatinine ratio (LNuACR), serum alkaline phosphatase, thyroid stimulating hormone, variability in systolic blood pressure and variability in LNuACR, lower glycated hemoglobin, high-density lipoprotein cholesterol and diastolic blood pressure, and lack of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription.

"The relatively high prevalence of diabetic kidney disease and 'rapid decliners' in a well-managed cohort of adults with diabetes highlights the need for urgent public health intervention and for optimization of diabetic kidney disease prevention/treatment strategies," the authors write.