Kidney damage seen in most patients with long-lasting T1D
Tina Costacou, Ph.D., and Trevor J. Orchard, M.D., from the University of Pittsburgh examined the 50-year cumulative kidney complication risk in 932 participants from a childhood-onset T1D cohort diagnosed during 1950 to 1980. Overall, 144 participants died before baseline (1986 to 1988), 130 were followed with periodic surveys, and 658 were followed with biennial surveys.
The researchers found that end-stage renal disease (ESRD) affected 60 percent of the cohort by 50 years of T1D duration, while macroalbuminuria and microalbuminuria affected 72 and 88 percent, respectively. In recent cohorts there was little evidence for declines in cumulative incidence, except for ESRD, which had a 45 percent decrease by 40 years of T1D duration, while microalbuminuria increased 3 percent and macroalbuminuria did not change. The lowest risk was seen for onset before age 6 years, and there was usually no difference in incidence by sex.
"Some degree of kidney disease in T1D is virtually universal at long durations and not declining, which has major implications for health care and research strategies," the authors write.
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