Early Identification of Kidney Disease

Kidney Image
 

Early Identification of Kidney Disease

The Importance of Early Identification

Why is it important to look for the early signs of diabetic kidney disease (DKD) in your patients with type 2 diabetes mellitus (T2DM)?

  • One of the earliest complications of T2DM is kidney decline1
  • If recognised early, kidney disease in diabetes can be effectively slowed down2
  • Early screening and using medications with proven effectiveness can reduce the burden of DKD2
  • 38% of patients with T2DM haven’t had a urine albumin check within the last year3

The role of ACR and eGFR as early markers of DKD

A bar graph showing progression of diabetic kidney disease
  • Whole-kidney GFR may remain normal even in the presence of considerable loss of nephron mass4
    • The graph indicates that by the time the estimated glomerular filtration rate (eGFR) falls below 60 mL/min/1.73 m2, the patient may have already lost 60-80% of their nephron mass4
  • By using ACR testing, early signs of DKD can be detected before significant nephron loss has occurred4

Using ACR and/or eGFR categories to assess a patients risk

  • 38% of patients with T2DM haven’t had a urine albumin check within the last year3
A bar graph showing risk of diabetes in a patient

Professor David Wheeler explains the importance of early detection of DKD in
people with T2DM

Abbreviations

ACR: Albumin Creatinine Ratio; DKD: Diabetic Kidney Disease; eGFR: estimated Glomerular Filtration Rate; T2DM: Type 2 Diabetes Mellitus.

References
  • 1. Afkarian M, Sachs MC, Kestenbaum B, et al. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol. 2013;24(2):302-308. doi:10.1681/ASN.2012070718.
  • 2. Diabetes UK. Position statement: Preventing kidney failure in people with diabetes (August 2016). Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/specialist-care-for-children-and-adults-and-complications/preventing-kidney-failure-in-people-with-diabetes [Accessed May 2021].
  • 3. National Diabetes Audit. Report: Care Processes and Treatment Targets, January to December 2019. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-audit/national-diabetes-audit-quarterly-report-january-to-december-2019 [Accessed May 2021].
  • 4. Tonneijck L, Muskiet M, Smits M et al. Glomerular Hyperfiltration in Diabetes: Mechanisms, Clinical Significance, and Treatment. J Am Soc Nephrol. 2017;28(4):1023-1039. doi:10.1681/asn.2016060666.
  • 5. KDIGO 2020. Clinical Practice Guidelines for Diabetes Management in Chronic Kidney Disease. http://kdigo.org/wp-content/uploads/2020/10/KDIGO-2020-Diabetes-in-CKD-GL.pdf [Accessed May 2021].
Reporting adverse events

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to Napp Pharmaceuticals Limited on 01223 424444 or drugsafetyuk@napp.co.uk.