New Research Findings

Newly published research has uncovered a concerning connection between prediabetes and chronic kidney disease (CKD), indicating that individuals diagnosed with prediabetes face substantial health risks, particularly if they also have hypertension or atherosclerotic cardiovascular disease (ASCVD).

Study Background

Recent data drawn from the Providence- and University of California Los Angeles Health-based Kidney Disease Research, Education, and Hope (CURE-CKD) Registry illustrate that patients with prediabetes can experience a swift progression to CKD. According to Dr. Radica Alicic, an associate director for research at Providence Health Care, 'People with prediabetes are at an elevated risk not only for diabetes and cardiovascular complications but potentially for chronic kidney disease, a looming public health crisis that emphasizes the need for effective management of blood sugar levels and associated risk factors.'

Understanding Prediabetes

Prediabetes is characterized by blood glucose levels that are higher than normal but not yet high enough for a diabetes diagnosis. Alarmingly, more than one in three adults in the U.S. were affected by prediabetes as of 2021, translating to about 97.6 million individuals aged 18 and older. The Centers for Disease Control and Prevention (CDC) highlights that prediabetes raises the risk of developing type 2 diabetes, heart disease, and stroke, and new findings suggest a similar risk elevation for CKD.

Incidence of CKD in Prediabetes Patients

To assess the incidence of CKD among patients with prediabetes, researchers scrutinized data from the CURE-CKD Registry, which provides a comprehensive view of electronic health records from key medical institutions for individuals with conditions like diabetes, hypertension, and prediabetes. Participants eligible for the study were at least 18 years old and met the American Diabetes Association's criteria for prediabetes based on specific blood test results.

Research Findings

The findings revealed that within a median follow-up duration of 2.5 years, 3.6% of the prediabetes cohort—comprising 281,933 participants—developed CKD, with a majority diagnosed via a significant decline in estimated glomerular filtration rate (eGFR). Notably, the overall incidence of CKD was found to be 10.9 cases per 1,000 person-years, with a marked increase observed particularly in males, older adults, and certain ethnic groups such as Native Hawaiians/Pacific Islanders and non-Hispanic Blacks.

Impact of Hypertension and ASCVD

Researchers specifically highlighted that the onset of CKD was notably accelerated among participants with hypertension or ASCVD, with an incidence rate of 11.9 per 1,000 person-years, compared to 9.4 in those without these conditions.

Recommendations and Conclusion

Dr. Alicic and her team emphasize that rapid-onset CKD is particularly prevalent among individuals with prediabetes coupled with hypertension or ASCVD, suggesting that proactive monitoring and intervention strategies are vital. They advocate for systematic approaches to manage glycemic levels and hypertension, particularly in higher-risk subpopulations, to mitigate the emerging threat of CKD in individuals with prediabetes.

As this research unfolds, it becomes increasingly clear that addressing prediabetes proactively could be a key factor in preventing chronic kidney disease.