Study shows diabetes-linked CKD cases on the rise among young adults

Ziyad Al-Aly The number of patients with late-stage chronic kidney disease increased significantly between 2002 and 2016 in the United States, with the bulk of the growth coming from adults aged 20 to 55 years old, according to a recently published paper .

“We were alarmed by the findings,” co-author Ziyad Al-Aly, MD, told H ealio N ephrology . “We expected to see that burden of CKD would rise as the U.S. population aged, but we were alarmed that the probability of death increased among those in the 20- to 54-year age group.”

From 1990 to 2016 in the United States, the probability of death decreased among young adults for most noncommunicable diseases, the paper noted. In this study, the probability of death due to CKD was increased among young adults, and this increase was in large part attributed to CKD due to diabetes.

The researchers found that, in 2016, nearly 2 million healthy life-years were lost and attributable to CKD, a 52.6% increase from 2002. During that period, nearly 83, 000 deaths were due to CKD, a 58.3% increase from 2002.

Reducing the cases of CKD, particularly among younger adults, requires a focus on reducing metabolic and dietary risks, the researchers noted.

“Diabetic kidney disease is the main driver of increased probability of death from kidney disease among the younger age groups,” Al-Aly said.

All states exhibited increases in cases of CKD, but the rate of change and the burden of disease was more significant in the southern United States. In Mississippi and Louisiana, for example, the number of cases was twice that seen in other states. Other high-risk areas included District of Columbia, Alabama, Georgia, West Virginia, Virginia, South Carolina, Maryland, Arkansas, Massachusetts, Delaware and Illinois, the researcher wrote. The variability in CKD burden attributable to risk exposure among states “suggests the need to examine potential policy levers or other precision-targeted population-wide mechanisms to influence or modulate the extent of exposure to these risk factors at the state level,” the researchers wrote.

“I think there needs to be more attention paid to the increased rates of CKD among those in the 20-to 54-[year] age group,” Al-Aly told H ealio N ephrology . “Our findings suggest not only increased burden of CKD among this segment of the population, but that it was driven by increased exposure to metabolic and dietary risk factors and most alarmingly this has resulted increased probability of death due to CKD among this young age group.

“The other take away is that burden of CKD has increased at a much faster rate than other noncommunicable diseases,” he said. “Effort needs to be devoted to stimulate progress in identifying therapies for CKD. Public health priorities, policy initiatives, funding allocation [and] advocacy effort[s] need to catch up to this reality that burden of CKD is rising, and the speed of change now outpaces other noncommunicable diseases. A concerted effort should be made to put the brakes on this.” – by Mark Neumann

Disclosure s : The authors report no relevant financial disclosures. This work was supported in part by funds from the Institute for Public Health at Washington University in St. Louis and the U.S. Department of Veterans Affairs.

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