What is the global prevalence of diabetic nephropathy?

Updated: Oct 09, 2019
  • Author: Vecihi Batuman, MD, FASN; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Striking epidemiologic differences exist even among European countries. In some European countries, particularly Germany, the proportion of patients admitted for renal replacement therapy exceeds the figures reported from the United States. In Heidelberg (southwest Germany), 59% of patients admitted for renal replacement therapy in 1995 had diabetes and 90% of those had type 2 DM. An increase in end-stage renal disease (ESRD) from type 2 DM has been noted even in countries with notoriously low incidences of type 2 DM, such as Denmark and Australia. Exact incidence and prevalence from Asia are not readily available.

A study from the Netherlands suggested that diabetic nephropathy is underdiagnosed. Using renal tissue specimens from autopsies, Klessens et al found histopathologic changes associated with diabetic nephropathy in 106 of 168 patients with type 1 or type 2 diabetes. However, 20 of the 106 patients did not during their lifetime present with the clinical manifestations of diabetic nephropathy. [13]

A retrospective study from China, by Fan and Wang, indicated that in type 2 diabetes patients with renal injury, there is a high prevalence of nondiabetic renal disease (NDRD). The investigators found that among 88 patients with type 2 diabetes who underwent renal biopsy, the incidence of NDRD was 72.73%, compared with 20.46% for diabetic nephropathy and 6.82% for diabetic nephropathy complicated with NDRD. Membranous nephropathy, immunoglobulin A (IgA) nephropathy, and focal segmental glomerulosclerosis were the most common NDRDs identified. [14]


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