US researchers have urged greater screening of kidney disease risks in people with type 1 diabetes of 50 years.
A new study published in Diabetes Care reveals that having type 1 diabetes for 50 years increases the risk of kidney disease, also known as diabetic nephropathy, and although incidences of kidney failure declined, incidences of microalbuminuria and macroalbuminuria did not.
“We must, therefore, expand our focus to intensively manage kidney disease risk factors (e.g., cholesterol, blood pressure) as well and encourage research projects aiming to identify currently unknown risk factors, since they may offer an additional opportunity to reduce the development of kidney disease,” said lead author Tina Costacou, PhD, associate professor of epidemiology at the University of Pittsburgh.
The study analysed 50-year cumulative kidney complication risk among a cohort of 932 people diagnosed with type 1 diabetes as children between 1950 and 1980.
The cumulative incidence of microalbuminuria, macroalbuminuria, kidney disease and all-cause mortality increased with longer diabetes duration. However, when comparing patients diagnosed after 1965 to those diagnosed between 1950 and 1965 a decline was observed in kidney disease rates.
One hypothesis for this is due to increased life expectancy among people with type 1 diabetes. This, the researchers believe, is attributable to greater improvements in diabetes care, meaning the number affected by kidney disease will also rise.
“It is, therefore, crucial that we are able to focus on prevention efforts and decrease the development of even early signs of kidney disease,” added Costacou.
People with diabetes can delay or prevent diabetic nephropathy by maintaining good control of blood sugar levels and blood pressure, as well as attending annual health checks so doctors can check for any early signs of kidney disease and take action to limit its progression.

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