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Study Shows Value of Screening Patients With Prediabetes

July 2010
Diabetes Strategy

Recognizing that patients with diabetes are at high risk for developing chronic kidney disease (CKD), the American Diabetes Association (ADA) recommends annual screening for CKD for these patients. A recent study that estimates the prevalence of CKD in prediabetic patients and patients with undiagnosed diabetes suggests that CKD screening may be warranted in the prediabetes population as well.

Researchers involved in the study, which was published online in the Clinical Journal of the American Society of Nephrology on March 25, analyzed a nationally representative sample of 8,188 Americans included in the National Health and Nutrition Examination Surveys. The surveys were conducted from 1999 through 2006. The researchers found that the prevalence of CKD was 10.6% in individuals without diabetes or prediabetes. In comparison, CKD was present in 17.7% of prediabetic individuals. Notably, 41.7% of individuals with undiagnosed diabetes had CKD, which was similar to the 39.6% rate seen in individuals who had been diagnosed with diabetes.

Recognizing a Threat
The findings indicate that kidney disease may be present and progressing before an individual’s diabetes is diagnosed. “Based on the results of this analysis, up to 13 million Americans who have undiagnosed diabetes or prediabetes already have signs of kidney damage or reduced kidney function, but may not know it,” says Laura Plantinga, ScM, assistant adjunct professor at the University of California San Francisco and lead author of the study. “These patients are at risk for worsening kidney disease and eventual end-stage renal disease.”

Screening for CKD
Diabetic and prediabetic patients may not understand that they are at a high risk for developing kidney disease. A December 2009 online survey of 203 family medicine physicians and 100 endocrinologists conducted by Sermo (an online physician community including more than 110, ....