Most racial and ethnic minority groups have higher rates of new cases of chronic kidney disease (CKD) than white Americans among adults with diabetes, according to a new study published in the New England Journal of Medicine.
Chronic kidney disease is often a complication of either type 1 or type 2 diabetes — especially among people with less-than-optimal blood glucose control, since high blood glucose levels can damage the tiny blood vessels in the kidneys that filter waste products from the blood. Research shows that for people with type 1 diabetes, early and more intensive treatment may reduce the risk for developing kidney disease. For people with type 2 diabetes, a group of drugs called SGLT2 inhibitors has been shown to be effective for both blood glucose control and slowing the progression of kidney disease — and may have additional benefits such as heart protection in this group. Another drug, Kerendia (finerenone), is a treatment specifically for diabetic kidney disease and has been shown to have the additional benefit of reducing the risk for pneumonia in people with type 2 diabetes and CKD.
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For the latest study, researchers looked rates of new-onset CKD in a group of 654,549 adults with diabetes who got health care from one of two large health systems in the western United States between 2015 and 2020. The average age of participants was 61, and 55% were women, as noted in an article on the study at Healio. New cases of CKD were confirmed by two positive laboratory tests performed at least 90 days apart, as shown in participants’ electronic health records.
Minorities with diabetes more likely to develop CKD
When new cases of CKD were broken down by racial and ethnic categories, the researchers found that compared with white participants, Native Hawaiian or Pacific Islander participants were 56% more likely to develop CKD — making this group the most likely to develop the condition. Black participants were 41% more likely to develop CKD, American Indian or Alaska Native participants were 33% more likely to develop CKD, and Hispanic or Latino participants were 25% more likely to develop CKD. The only minority group that was less likely to develop CKD than white participants was Asian participants, who were 13% less likely to develop the condition.
There was some good news when it came to overall rates of new-onset CKD. In 2015-2016, the incidence of CKD was 81.6 per 1,000 years of life among all participants, while in 2019-2020 it was 64.0 per 1,000 years of life. The trend of declining new cases of CKD was seen in all racial and ethnic groups, in both men and women, and in all age groups of participants.
“Given the rapidly growing population with diabetes in the United States and the corresponding high rates of kidney failure, the persistently high incidence of CKD marked by racial and ethnic disparities is troubling,” said study author Katherine Tuttle, MD, a professor of medicine at the University of Washington, in a news release on the study. “Inclusive strategies for prevention, detection, and intervention are needed to reduce CKD risk in people with diabetes.”
Want to learn more about keeping your kidneys healthy with diabetes? Read “Managing Diabetic Kidney Disease,” “How to Keep Your Kidneys Healthy,” “Protecting Your Kidneys,” and “Kidney Disease: Your Seven-Step Plan for Prevention.”
