Epidemiology of Diabetic Kidney Disease

Diabetes currently affects 8.3% of the world's adults and will increase in prevalence in future decades. Diabetic kidney disease is a leading cause of end stage renal disease (ESRD) and health care expenditure. Diabetic kidney disease can develop along an albuminuric or non-albuminuric pathway. The risks of death from all causes and from cardiovascular disease increase with lower glomerular filtration rates. For those with albuminuria, the risks of ESRD and of all-cause mortality and cardiovascular mortality increase with higher levels of albumin excretion. Survival has improved compared to outcomes from the 1980s, and progression to ESRD is now more common than premature death. This chapter reviews the epidemiology of diabetic kidney disease in type 1 and type 2 diabetes.