Overview of diabetic kidney disease

Published on March 30, 2023   43 min

A selection of talks on Physiology & Anatomy

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Hello everyone. My name is Ashish Upadhyay. I'm Associate Professor of Medicine at Boston University, Chobanian & Avedisian School of Medicine. The title of our talk today is Overview of Diabetic Kidney Disease.
During the course of the presentation, we will go through brief epidemiology and natural history of diabetic kidney disease, pathogenesis of diabetic kidney disease, and management of diabetic kidney disease. First, let's talk about epidemiology and natural history of diabetic kidney disease.
Diabetic kidney disease is defined as estimated GFR of less than 60 ml/min or albuminuria as defined by urine albumin creatinine ratio (UACR) of more than 30 mg/g in individuals with diabetes. It is estimated that approximately half of individuals with type 2 diabetes and a third of individuals with type 1 diabetes develop diabetic kidney disease. It remains the number one cause of kidney failure in most parts of the world, but as you can see from the table here, that looks at data from various national and international cohorts, that there are major racial and ethnic disparities in the prevalence of diabetic kidney disease.
The importance of diabetic kidney disease is because of its high level of morbidity and mortality, as you can see from this data in 5% of the Medicare sample in the United States. The risk of diabetic kidney disease is that it increases the risk of death and in this particular sample, if you have diabetic kidney disease, the risk of death was 6.1% over two years vs the risk of 0.3% without chronic kidney disease with just diabetes.