A large number of people diagnosed with type 2 diabetes show symptoms of chronic kidney disease (CKD) before their diabetes diagnosis, researchers report.
People with diabetes face an increased risk of kidney disease, but this new study reveals kidney damage could occur much earlier than expected.
Scientists from the University of Tennessee Health Science Center and VA MidSouth Healthcare Network say that greater awareness of CKD risk factors is required among doctors, particularly with regard to those at risk of type 2 diabetes.
“Better awareness of the risk factors for CKD – for example, high blood pressure, obesity, cardiovascular disease, race-ethnicity, family history – is needed for health care providers to become proactive about screening for early-stage CKD,” said study author Dr. Csaba Kovesdy.
The researchers examined electronic health records from 36,794 veterans who were diagnosed with type 2 diabetes between 2003-2013. A total of 31.6% had signs of CKD prior to their diabetes diagnosis.
Higher age, HbA1c, blood pressure and BMI correlated with increased CKD risk, which are all risk factors for type 2 diabetes. Health complications such as peripheral artery disease were also associated with higher CKD risk.
Kovesdy and colleagues proposed two hypotheses for CKD signs appearing before diabetes diagnosis. The first is because type 2 diabetes can be undiagnosed for several months, or even years, the kidneys can become damaged without patient or doctor knowledge. The second theory is that kidney damage occurs because of other conditions, such as obesity, and other common risk factors for type 2 diabetes.
The researchers concluded that additional kidney screening of at-risk patients could enable earlier identification of diabetes and ensure better preventative measures to protect the kidneys.
The findings have been published online in the journal PLoS One.
Editor’s note: Kidney damage is often treated in a number of ways, including diet and exercise. People at a high risk of diabetes or with early signs of kidney damage can lessen the severity of progression by making healthy lifestyle changes, such as avoiding alcohol and smoking, and keeping good control of blood glucose levels and weight management.

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