Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014

摘要: Importance Diabetic kidney disease is the leading cause of chronic and end-stage in United States worldwide. Changes demographics treatments may affect prevalence clinical manifestations diabetic disease. Objective To characterize among US adults with diabetes over time. Design, Setting, Participants Serial cross-sectional studies aged 20 years or older mellitus participating National Health Nutrition Examination Surveys from 1988 through 2014. Exposures Diabetes was defined as hemoglobin A 1c greater than 6.5% use glucose-lowering medications. Main Outcomes Measures Albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g), macroalbuminuria ≥300 reduced estimated glomerular filtration rate (eGFR 2 ), severely eGFR ( incorporating data on biological variability to estimate persistent abnormalities. Results There were 6251 included (1431 1988-1994, 1443 1999-2004, 1280 2005-2008, 2097 2009-2014). The any disease, albuminuria, eGFR, both, did not significantly change time 28.4% (95% CI, 23.8%-32.9%) 1988-1994 26.2% 22.6%-29.9%) 2009-2014 (prevalence ratio, 0.95 [95% 0.86-1.06] adjusting for age, sex, race/ethnicity; P  = .39 trend). However, albuminuria decreased progressively 20.8% 16.3%-25.3%) 15.9% 12.7%-19.0%) (adjusted 0.76 0.65-0.89];  = .004 Significant heterogeneity temporal trend noted by age  = .049 interaction) race/ethnicity  = .007 interaction), a decreasing observed only younger 65 non-Hispanic whites, whereas GFR increased without significant differences race/ethnicity. In 2009-2014, approximately 8.2 million 6.5-9.9 adults) had both. Conclusions Relevance Among 2014, overall significantly, declined increased.