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- Title
Acute Kidney Injury: A Bona Fide Complication of Diabetes.
- Authors
Advani, Andrew
- Abstract
The landscape of kidney disease in diabetes has shifted. The classical dogma of "diabetic nephropathy" progressing through stages of albuminuria, leading to decline in glomerular filtration rate and end-stage kidney disease (ESKD), has been replaced by a more nuanced understanding of the complex and heterogeneous nature of kidney disease in diabetes. Paralleling this evolution, standardized definitions have resulted in a growing appreciation that acute kidney injury (AKI) is increasing in its incidence rapidly and that people with diabetes are much more likely to develop AKI than people without diabetes. Here, I propose that AKI should be considered a complication of diabetes alongside other complications that similarly do not fit neatly into the historical microvascular/macrovascular paradigm. In this article, we take a look at the evidence indicating that diabetes is a major risk factor for AKI and we review the causes of this increased risk. We consider the long-term implications of AKI in diabetes and its potential contribution to the future development of chronic kidney disease, ESKD, and mortality. Finally, we look toward the future at strategies to better identify people at risk for AKI and to develop new approaches to improve AKI outcomes. Recognizing AKI as a bona fide complication of diabetes should open up new avenues for investigation that may ultimately improve the outlook for people living with diabetes and at risk for kidney disease.
- Subjects
DIABETES complications; ACUTE kidney failure; CHRONIC kidney failure; DIABETIC nephropathies; GLOMERULAR filtration rate; COMPARATIVE studies; TYPE 1 diabetes; RESEARCH methodology; MEDICAL cooperation; TYPE 2 diabetes; RESEARCH; EVALUATION research; DISEASE complications
- Publication
Diabetes, 2020, Vol 69, Issue 11, p2229
- ISSN
0012-1797
- Publication type
journal article
- DOI
10.2337/db20-0604