Tuttle, KR and Nelson, RG.   The New KDOQI^TM Guidelines for diabetes and chronic kidney disease (CKD) NKF Family Focus 16:14-15, 2008

Nearly 21 million Americans have diabetes. Five to 10 percent of them have Type 1 diabetes, which develops because of the body's failure to make insulin. Most others have Type 2 diabetes, which develops because of the body's failure to properly use the insulin it makes.

It is predicted that the number of people with diabetes will increase 165 percent between 2000 and 2050, with the greatest increases occurring in people over 75 years of age and African Americans (1). Children are also increasingly affected by diabetes. Mostly, these increases are due to the alarming rise in obesity rates. Diabetes is the leading cause of chronic kidney disease (CKD) in the United States. About half of the people who have diabetes (Type 1 and 2) develop kidney disease. Microalbuminuria, or small amounts of the protein albumin in the urine, is an early sign of kidney disease that is found in 43 percent of people with diabetes (2). Macroalbuminuria, or larger amounts of urinary albumin, is a sign of more serious kidney damage and is present in eight percent of individuals who have diabetes (2). Diabetes is also responsible for 45 percent of new kidney failure cases that require dialysis or a kidney transplant, up from 18 percent in 1980 (3). The fact that  diabetes and CKD are sometimes not diagnosed early enough means that people may not receive the correct care and may develop CKD at a faster rate.

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