1.2.0.0 Epi­demi­ol­o­gy of Di­a­betes and Chron­ic Kid­ney Dis­ease

Chron­ic kid­ney dis­ease (CKD) is di­ag­nosed by the per­sis­tent pres­ence of el­e­vat­ed uri­nary al­bu­min ex­cre­tion (al­bu­minuria), low es­ti­mat­ed glomeru­lar filtra­tion rate (eGFR), or other man­i­fes­ta­tions of kid­ney dam­age (1,2). In this sec­tion, the focus will be on CKD at­tribut­ed to di­a­betes (di­a­bet­ic kid­ney dis­ease), which oc­curs in 20–40% of pa­tients with di­a­betes (1,3–5). CKD typ­i­cal­ly de­vel­ops after di­a­betes du­ra­tion of 10 years in type 1 di­a­betes but may be pre­sent at di­ag­no­sis of type 2 di­a­betes. CKD can progress to end-‍stage renal dis­ease (ESRD) re­quir­ing dial­y­sis or kid­ney trans­plan­ta­tion and is the lead­ing cause of ESRD in the U.S. (6). In ad­di­tion, among peo­ple with type 1 or 2 di­a­betes, the pres­ence of CKD marked­ly in­creas­es car­dio­vas­cu­lar risk and health care costs (7).