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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.
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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.
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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.
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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.
