Type 1 Diabetes Patients Need New Kidney Therapies: Study
Recent advances not enough in preventing end-stage disease, researchers say
THURSDAY, Feb. 24, 2011 (HealthDay News) -- Despite major advances in kidney care over the last two decades, type 1 diabetes patients with kidney dysfunction still have high rates of kidney failure and heart-related death, researchers have found.
The findings show that more effective treatments are needed for these patients, according to the authors of the new study.
One-third of type 1 diabetes patients develop macroalbuminuria, a condition where high amounts of protein are lost through the urine. These patients are at increased risk for kidney failure (end-stage renal disease) and death from heart-related causes, the researchers explained in a news release from the American Society of Nephrology.
The new study included 423 white patients with type 1 diabetes who developed macroalbuminuria and were enrolled in the study between 1991 and 2004. Most of the patients (98 percent) were followed through 2008.
During the follow-up, 172 patients developed end-stage renal disease, and 70 of these patients died. Another 29 study participants died before developing end-stage renal disease.
Between 1991 and 2008, more patients received treatments to protect their kidneys (treatments increased from 56 percent to 82 percent) and significant improvements were noted in patients' blood pressure and cholesterol levels. However, the risks for both end-stage disease and death before developing end-stage disease did not change over the study period.
The investigators also found that patients who had kidney transplants before they had to start dialysis were less likely to die.
"Our findings clearly indicate that the accomplishments in treatment of patients with type 1 diabetes and macroalbuminuria over the last 20 years are not effective enough, and more effective therapies to retard progression to end-stage renal disease are desperately needed," study author Dr. Andrzej Krolewski, of the Joslin Diabetes Center and Brigham and Women's Hospital in Boston, said in the news release.
"New therapies need to be developed including more aggressive or experimental protocols to stop or retard declining renal function, which leads to end-stage renal disease," Krolewski added.
The study was released online in advance of publication in an upcoming print issue of the Journal of the American Society of Nephrology.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes.