November 21, 2011

What Causes Kidney Disease in Type I Diabetes Patients?

(Ivanhoe Newswire) — Impaired glomerular filtration rate (GFR) in the kidney leads to end-stage renal disease and increases the risk of cardiovascular disease and death. Patients with Type I diabetes are at an increased for kidney disease, but there are no interventions that have proved to prevent impaired GFR in these people. According to this study, intensive diabetes therapy may prevent kidney disease in type I diabetes patients.

In the Diabetes Control and Complications Trial (DCCT), 1441 people with type 1 diabetes were randomly assigned to 6.5 years of intensive diabetes therapy to achieve as close to normal serum glucose levels as possible. Then, 1375 participants were followed in the Epidemiology of Diabetes Interventions and Complications (EDIC) study. Serum creatinine levels, the number one sign of kidney disease, were measured annually throughout the course of the study. Researchers estimated the GFR, and then analyzed the data from the two studies to determine the long-term effects of intensive diabetes therapy on the risk of impaired GFR.

Researchers found that impaired GFR was seen in 24 participants assigned to intensive therapy, and 46 assigned to conventional therapy. Among these participants, end-stage renal disease developed in eight patients with intensive therapy and 16 in the conventional group.

The long-term risk of an impaired GFR was much lower in patients treated early in the course of type I diabetes with intensive diabetes therapy than among those treated with conventional diabetes therapy.

SOURCE: The New England Journal of Medicine, published online November 11, 2011