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      Diabetic kidney disease: world wide difference of prevalence and risk factors

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          Abstract

          Diabetic kidney disease – which is defined by elevated urine albumin excretion or reduced glomerular filtration rate (GFR) or both – is a serious complication that occurs in 20% to 40% of all diabetics. In this review we try to highlight the prevalence of diabetic nephropathy which is not uncommon complication of diabetes all over the world. The prevalence of diabetes worldwide has extended epidemic magnitudes and is expected to affect more than 350 million people by the year 2035. There is marked racial/ethnic besides international difference in the epidemiology of diabetic kidney disease which could be explained by the differences in economic viability and governmental infrastructures. Approximately one-third of diabetic patients showed microalbuminuria after 15 years of disease duration and less than half develop real nephropathy. Diabetic kidney disease (DKD) is more frequent in African-Americans, Asian-Americans, and Native Americans. Progressive kidney disease is more frequent in Caucasians patients with type 1 than type 2 diabetes mellitus (DM), although its overall prevalence in the diabetic population is higher in patients with type 2 DM while this type of DM is more prevalent. Hyperglycemia is well known risk factor for in addition to other risk factors like male sex, obesity, hypertension, chronic inflammation, resistance to insulin, hypovitaminosis D, and dyslipidemia and some genetic loci and polymorphisms in specific genes. Management of its modifiable risk factors might help in reducing its incidence in the nearby future.

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          Epidemic obesity and type 2 diabetes in Asia.

          Kun-Ho Yoon, Jin-Hee Lee, Ji-Won Kim … (2006)
          The proportions of people with type 2 diabetes and obesity have increased throughout Asia, and the rate of increase shows no sign of slowing. People in Asia tend to develop diabetes with a lesser degree of obesity at younger ages, suffer longer with complications of diabetes, and die sooner than people in other regions. Childhood obesity has increased substantially and the prevalence of type 2 diabetes has now reached epidemic levels in Asia. The health consequences of this epidemic threaten to overwhelm health-care systems in the region. Urgent action is needed, and advocacy for lifestyle changes is the first step. Countries should review and implement interventions, and take a comprehensive and integrated public-health approach. At the level of primary prevention, such programmes can be linked to other non-communicable disease prevention programmes that target lifestyle-related issues. The cost of inaction is clear and unacceptable.
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            Economic costs of diabetes in the U.S. In 2007.

            (2008)
            The prevalence of diabetes continues to grow, with the number of people in the U.S. with diagnosed diabetes now reaching 17.5 million. The objectives of this study are to quantify the economic burden of diabetes caused by increased health resource use and lost productivity, and to provide a detailed breakdown of the costs attributed to diabetes. This study uses a prevalence-based approach that combines the demographics of the population in 2007 with diabetes prevalence rates and other epidemiological data, health care costs, and economic data into a Cost of Diabetes Model. Health resource use and associated medical costs are analyzed by age, sex, type of medical condition, and health resource category. Data sources include national surveys and claims databases, as well as a proprietary database that contains annual medical claims for 16.3 million people in 2006. The total estimated cost of diabetes in 2007 is $174 billion, including $116 billion in excess medical expenditures and $58 billion in reduced national productivity. Medical costs attributed to diabetes include $27 billion for care to directly treat diabetes, $58 billion to treat the portion of diabetes-related chronic complications that are attributed to diabetes, and $31 billon in excess general medical costs. The largest components of medical expenditures attributed to diabetes are hospital inpatient care (50% of total cost), diabetes medication and supplies (12%), retail prescriptions to treat complications of diabetes (11%), and physician office visits (9%). People with diagnosed diabetes incur average expenditures of $11,744 per year, of which $6,649 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures that are approximately 2.3 times higher than what expenditures would be in the absence of diabetes. For the cost categories analyzed, approximately $1 in $5 health care dollars in the U.S. is spent caring for someone with diagnosed diabetes, while approximately $1 in $10 health care dollars is attributed to diabetes. Indirect costs include increased absenteeism ($2.6 billion) and reduced productivity while at work ($20.0 billion) for the employed population, reduced productivity for those not in the labor force ($0.8 billion), unemployment from disease-related disability ($7.9 billion), and lost productive capacity due to early mortality ($26.9 billion). The actual national burden of diabetes is likely to exceed the $174 billion estimate because it omits the social cost of intangibles such as pain and suffering, care provided by nonpaid caregivers, excess medical costs associated with undiagnosed diabetes, and diabetes-attributed costs for health care expenditures categories omitted from this study. Omitted from this analysis are expenditure categories such as health care system administrative costs, over-the-counter medications, clinician training programs, and research and infrastructure development. The burden of diabetes is imposed on all sectors of society-higher insurance premiums paid by employees and employers, reduced earnings through productivity loss, and reduced overall quality of life for people with diabetes and their families and friends.
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              Nephropathy in diabetes.

              Mark Molitch, Ralph A. DeFronzo, Marion Franz … (2004)
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Nephropharmacol
                Journal ID (iso-abbrev): J Nephropharmacol
                Journal ID (publisher-id): J Nephropharmacol
                Journal ID (pmc): J Nephropharmacol
                Journal ID (publisher-id): NPJ
                Title: Journal of Nephropharmacology
                Publisher: Society of Diabetic Nephropathy Prevention
                ISSN (Electronic): 2345-4202
                Publication date Collection: 2016
                Publication date (Electronic): 09 October 2015
                Volume: 5
                Issue: 1
                Pages: 49-56
                Affiliations
                1Urology and Nephrology Center, Mansoura University, Egypt
                2Department of Nephrology, Hamed Al-Essa Organ Transplant Center, Kuwait
                3Faculty of Nursing, Mansoura University, Mansoura, Egypt
                4Dasman Diabetes institute, Kuwait
                Author notes
                [* ] Corresponding author: Osama Gheith, ogheith@ 123456yahoo.com
                Article
                DOI: 10.4103/1110-9165.197379
                PMC ID: 5297507
                PubMed ID: 28197499
                SO-VID: e3e28267-9960-4dfd-a25a-c6a38a99a245
                Copyright © © 2016 The Author(s)
                License:

                Published by Society of Diabetic Nephropathy Prevention. This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 September 2015
                Date accepted : 04 October 2015
                Page count
                References: 65, Pages: 8
                Categories
                Subject: Review

                Keywords: diabetic kidney disease,end-stage kidney disease,glomerular filtration rate,type 2 diabetes,microalbuminuria,chronic kidney disease
                Data availability:
                Keywords: diabetic kidney disease, end-stage kidney disease, glomerular filtration rate, type 2 diabetes, microalbuminuria, chronic kidney disease

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