Week 2: Epidemiology

Hi everyone! Welcome back to our study of diabetic nephropathy...after an amazing Seahawks win!! This week we are going to jump into the study of epidemiology. We will be looking at the different factors that contribute to the development of diabetic nephropathy like age, race, gender, etc. It is my goal to further investigate this disease with you. So here we go....

HISTORY
Diabetic nephropathy (kidney disease) is a common complication of diabetes. The disease was first discovered by the physician Clifford Wilson in 1936 but wasn't widely noted until the 1980s (NIH). The prevalence of diabetic nephropathy increased from 1988-2008 in proportion to an increase in diabetes. In fact, recent statistics say that diabetic nephropathy affects 366 million people in the United States with type 1 and type 2 diabetes (NIH). Now that is a lot of people with kidney disease! And since so many people are affected by this disease it is important that we recognize some of the factors that can influence its' prevalence.

RISK FACTORS
Several of the greatest risk factors for developing diabetic nephropathy include...

1. Poor blood glucose control. Regulating blood glucose is a big part of controlling your diabetes. You are at an increased risk for developing diabetic nephropathy if your A1C is greater than 11% (WHO).

2. Elevated blood pressure. Having uncontrolled blood pressure- or hypertension- is also a large risk factor for developing kidney disease. Consult with your physician if you repeatedly have elevated blood pressure (WHO).

3. The older you are the greater your risk of developing kidney disease. And so are the perils of life...Having diabetes for a longer period of time in coordination with getting older will increase your chance of developing diabetic nephropathy (WHO).

A combination of any of these risk factors even further increases your risk of developing diabetic nephropathy. So make sure you are paying attention to your health!

AGE 
The mean age of people affected by diabetic nephropathy is 60. Most people develop diabetic nephropathy after having diabetes for 10-20 years so like I said earlier the older you are the greater the risk.  In general, the incidence of kidney disease is higher among the elderly in general (NIH).

GENDER
Males and females have the same incidence of diabetic nehpropathy. So no matter what sex you identify with make sure you understand the risks relative to all (NIH).

RACE
African Americans, Mexican Americans and Pima Indians have a 3-6 fold higher incidence rate. This suggests that socioeconomic factors like diet, hypertension, obesity, and poor control of blood glucose levels have a primary role in the development of diabetic neuropathy. These results also show a possible genetic of familial contribution (NIH). So pay attention to your past. Does diabetic nephropathy run in your family? If so, talk to your provider sooner rather than later.

LOCATION
The United States has one of the lowest rates for kidney replacement surgery which is an indication for progressive diabetic nephropathy. Countries like Germany, Denmark and Australia have higher incidences of kidney replacement surgery for issues like diabetic nephropathy. This means that if you live in the United States you have lower risk of developing diabetic nephropathy.

It is also important to notice distribution of kidney disease throughout the United States. The southern states are more affected by diabetic nephropathy which can be attributed to higher incidences of diabetes and obesity.

MORTALITY AND MOBIDITY
As of 2013, it has beed shown that only 34% of patients live longer than five years following treatment for diabetic nephropathy and end-stage kidney disease (UpToDate). This data shows that survival rates are poor.

Okay guys...thanks again for joining me on our path to discovering diabetic nephropathy! I hope you learned from this blog post and I can't wait to see you next week! Go Hawks!



This information was provided to you from the following sources...

"Dialysis in Diabetic Nephropathy." Dialysis in Diabetic Nephropathy. N.p., n.d. Web. 13 Jan. 2015.
"About Diabetes." WHO. N.p., n.d. Web. 13 Jan. 2015.
Lewis, Dirksen, Heitkemper, and Bucher. Medical-Surgical Nursing: Assessment and management of Clinical Problems. 9th edition. St. Louis, Missouri: Elsevier; 2014. 

Chen, Jing. Diabetic Nephropathy: The Scope of the Problem. Diabetes and Kidney Disease. 2014, XIV, p. 256. 2013. 

Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. US Department of Health and Human Services. Atlanta, GA: Centers for Disease Control and Prevention; 2011.