Approximately 20% to 40% of patients with type 1 or type 2 diabetes mellitus develop DKD.[1]American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care. 2024 Jan;47(suppl 1):S1-321.
https://diabetesjournals.org/care/issue/47/Supplement_1
[4]Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: challenges, progress, and possibilities. Clin J Am Soc Nephrol. 2017 May 18;12(12):2032-45.
https://journals.lww.com/cjasn/fulltext/2017/12000/diabetic_kidney_disease__challenges,_progress,_and.17.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28522654?tool=bestpractice.com
The epidemiology of DKD has been best studied in patients with type 1 diabetes, since the time of clinical onset is usually known. Approximately 20% to 30% will have moderately increased albuminuria (previously known as microalbuminuria) after a mean duration of diabetes of 15 years.[5]Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gantenbein C. Diabetic nephropathy in type 1 diabetes: a review of early natural history, pathogenesis, and diagnosis. Diabetes Metab Res Rev. 2017 Feb;33(2):dmrr.2841.
http://www.ncbi.nlm.nih.gov/pubmed/27457509?tool=bestpractice.com
In a cohort of patients with childhood-onset type 1 diabetes, after 50 years 60% had end-stage renal disease, 72% had severely increased albuminuria (previously known as macroalbuminuria), and 88% had moderately increased albuminuria.[6]Costacou T, Orchard TJ, et al. Cumulative kidney complication risk by 50 years of type 1 diabetes: the effects of sex, age, and calendar year at onset. Diabetes Care. 2018 Mar;41(3):426-33.
http://www.ncbi.nlm.nih.gov/pubmed/28931542?tool=bestpractice.com
DKD may be present at diagnosis of type 2 diabetes.[1]American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care. 2024 Jan;47(suppl 1):S1-321.
https://diabetesjournals.org/care/issue/47/Supplement_1
Although in the past it was stated that the risk of nephropathy was less in type 2 than type 1 diabetes, a study of the first decade of diabetes duration showed that albuminuria progression was actually more common in type 2 versus type 1 diabetes.[7]Ritz E, Orth SR. Nephropathy in patients with type 2 diabetes mellitus. N Engl J Med. 1999 Oct 7;341(15):1127-33.
http://www.ncbi.nlm.nih.gov/pubmed/10511612?tool=bestpractice.com
[8]Kahkoska AR, Isom S, Divers J, et al. The early natural history of albuminuria in young adults with youth-onset type 1 and type 2 diabetes. J Diabetes Complications. 2018 Oct 4;32(12):1160-8.
http://www.ncbi.nlm.nih.gov/pubmed/30316542?tool=bestpractice.com
The prevalence of DKD is increasing and reflects the rise in prevalence of diabetes worldwide.[4]Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: challenges, progress, and possibilities. Clin J Am Soc Nephrol. 2017 May 18;12(12):2032-45.
https://journals.lww.com/cjasn/fulltext/2017/12000/diabetic_kidney_disease__challenges,_progress,_and.17.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28522654?tool=bestpractice.com
Diabetes mellitus is the most common cause of chronic kidney disease worldwide.[9]GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 8;392(10159):1789-858.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32279-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/30496104?tool=bestpractice.com