Cited by 1,153Chronic Kidney Disease and DiabetesDiabetes Management and ResearchDialysis and Renal Disease Management

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Diabetic Kidney Disease: A Report From an ADA Consensus Conference

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Tuttle, Katherine R., Bakris, George L., Bilous, Rudolf W., Chiang, Jane L., de Boer, Ian H., Goldstein-Fuchs, Jordi, Hirsch, Irl B., Kalantar-Zadeh, Kamyar, Narva, Andrew S., Navaneethan, Sankar D., Neumiller, Joshua J., Patel, Uptal D., Ratner, Robert E., Whaley-Connell, Adam T., Molitch, Mark E.·2014·Diabetes Care

DOI 10.2337/dc14-1296PMC PMC4170131

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Abstract

The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included 1) identification and monitoring, 2) cardiovascular disease and management of dyslipidemia, 3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, 4) glycemia measurement, hypoglycemia, and drug therapies, 5) nutrition and general care in advanced-stage chronic kidney disease, 6) children and adolescents, and 7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.

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Should We STOP Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers in Advanced Kidney Disease?
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Self-citation
Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy
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Authors: Tuttle, K. R., Bakris, G. L., Bilous, R. W., Chiang, J. L., de Boer, I. H., Goldstein-Fuchs, J., Hirsch, I. B., Kalantar-Zadeh, K., Narva, A. S., Navaneethan, S. D., Neumiller, J. J., Patel, U. D., Ratner, R. E., Whaley-Connell, A. T., & Molitch, M. E.
Affiliations: University of Washington (US)
National Kidney Foundation (US)
Newcastle University (GB)
American Diabetes Association (US)
Division of Nephrology, University of Washington, Seattle, WA
Sierra Nevada Nephrology Consultants, Reno, NV
School of Medicine, University of California, Irvine, Irvine, CA
National Institutes of Health (US)
Cleveland Clinic (US)
Washington State University Spokane (US)
Duke University (US)
Harry S. Truman Memorial Veterans Hospital, Columbia, MO, and Department of Internal Medicine, Division of Nephrology and Hypertension, University of Missouri School of Medicine, Columbia, MO
Northwestern University (US)
Corresponding author: Chiang, Jane L.
ORCID: Tuttle, Katherine R.
Bakris, George L.
Chiang, Jane L.
Hirsch, Irl B.
Navaneethan, Sankar D.
Neumiller, Joshua J.
Patel, Uptal D.
Molitch, Mark E.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2014-09-10
Volume: 37
Issue: 10
Pages: 2864-2883
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc14-1296
PMC: PMC4170131
OpenAlex: W2072070798
Semantic Scholar: 0c6864a569d8918ea51eda33aae122cff819ac65
Cited by: 1,153
References: 193
Citations by year: 2026: 90 · 2025: 104 · 2024: 107 · 2023: 131 · 2022: 128 · 2021: 118 · 2020: 130 · 2019: 87 · 2018: 87 · 2017: 72 · 2016: 65 · 2015: 27 · 2014: 6
FWCI: 44.80
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Amgen
Bristol-Myers Squibb
Eli Lilly and Company
AstraZeneca
Sanofi
Gilead Sciences
Halozyme
Luitpold Pharmaceuticals
Angion
Novo Nordisk
CSL Limited
National Institutes of Health (UL1TR000430)
Relypsa
National Institute of Diabetes and Digestive and Kidney Diseases
National Center for Advancing Translational Sciences
Daiichi Sankyo Europe
Topics: Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords: diabetic nephropathy, end-stage renal disease, type 2 diabetes, chronic kidney disease, cardiovascular disease, dyslipidemia, hypertension, renin-angiotensin-aldosterone system blockade, mineralocorticoid receptor antagonists, glycemic control, hypoglycemia, pharmacotherapy, pediatric diabetes, multidisciplinary care, patient-centered medical home, health care delivery
MeSH terms: Adolescent, Aged, Antihypertensive Agents, Blood Glucose, Cardiovascular Diseases, Child, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Humans, Kidney Function Tests, Middle Aged, Incidence, Prevalence, Renal Insufficiency, Chronic

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