Type 2 diabetics with kidney disease at greater risk of early death

It is well known that having type 2 diabetes increases the risk of premature death, but a new observational study suggests that this elevated risk is primarily confined to type 2 diabetics who also have kidney disease .
Researchers from the University of Washingto, Seattle, and colleagues found that people with type 2 diabetes are significantly more likely to die early if they also suffer from kidney disease, which is one of the major complications of long-term elevated blood glucose levels.
Maryam Afkaria, MD, from the University of Washingto, Seattle, and colleagues examined 10-year mortality rates in over 15,000 US adults with type 2 diabetes and/or kidney diseas.
Kidney disease was present in 42.3 per cent of individuals with type 2 diabetes and 9.4 per cent of those without the metabolic disorder.
The researchers reported that 7.7 per cent of people without kidney disease or type 2 diabetes (reference group) and 11.5 per cent of those with type 2 diabetes but no kidney disease died over the course of the ten-year study. However, the mortality rate for individuals with both conditions was much higher at 31.1 per cent.
“People with type 2 diabetes have many other risk factors for cardiovascular disease and mortality, so we expected that kidney disease would predict a part, but not a majority, of higher mortality associated with type 2 diabetes,” Dr Afkarian said.
“To our surprise, we found that even in the medically complex patients with type 2 diabetes, kidney disease is a very powerful predictor of premature death.”
She added that targeting this group of patients for intensive treatment designed to reduce the risk of cardiovascular disease, or working harder to prevent kidney disease from developing may be a powerful ways of reducing mortality in people with diabetes .
The findings are published online in the Journal of the American Society of Nephrology.