Diabetes Becomes Top Cause of Chronic Kidney Disease in China

Diabetes has overtaken glomerulonephritis as the most common cause of chronic kidney disease (CKD) in China, according to a research letter in The New England Journal of Medicine.

Using Chinese national hospital and population databases, the researchers analyzed trends in CKD from 2010 through 2015. Based on medical history and laboratory data, cases of CKD were classified as related to diabetes or glomerulonephritis.

In 2010, the percentage of hospitalized patients with diabetes-related CKD was 0.82% and 1.01% with CKD related to glomerulnephritis. The percentage with diabetes-related CKD became larger starting in 2011, with a widening gap in subsequent years. By 2015, the figures were 1.10% for diabetes-related CKD versus 0.75% for glomerulonephritis-related CKD.

In a nationally representative population sample of about 47,000 participants in 2009–10, the percentage with diabetes-related CKD was 1.23% while 0.91% had glomerulonephritis-related CKD. Diabetes-related CKD was more prevalent in both urban and rural areas, although the difference was smaller for rural residents.

In developing countries, glomerulonephritis has been the predominant cause of end stage renal disease. In China, the prevalence of diabetes has increased in recent decades.

The new findings show that diabetes is now the predominant cause of CKD in China, in hospitalized patients as well as in the general population. Based on a 21.3% rate of CKD among diabetics, the researchers estimate there are 24.3 million patients with diabetes-related CKD in China [Zhang L, et al. Trends in chronic kidney disease in China. N Engl J Med 2016; 375:905–906].

October/November 2016 (Vol 8, Issue 10/11)