Abstract

Background: Despite the fact that diabetic kidney disease is a common condition, the incidence among people with diabetes has not been systematically reviewed. We therefore conducted a systematic review of published articles that reported the incidence of kidney disease in diabetes.

Methods: A systematic literature search was performed using MEDLINE, EMBASE and CINAHL databases. The titles and abstracts of all publications identified by the search were reviewed and 9038 studies were retrieved. The review was conducted according to the PRISMA guidelines.

Results: A total of 63 studies from 29 different countries with sample sizes ranging from 505 to 211,132 met the inclusion criteria. From the period 1990–2015, there were 34 clinic-based, 17 registry-based and 12 population-based studies included. The annual incidence of microalbuminuria and albuminuria ranged from 1.3–3.8% for type 1 diabetes (T1D). For type 2 diabetes (T2D) and studies combining both diabetes types, the range was from 2.2–12.7%, with 4 out of the 7 studies reporting annual rates between 7.4 and 8.6%. In studies defining chronic kidney disease as eGFR<60 ml/min/1.73m², apart from one study which reported an annual incidence of 8.9%, the annual incidence ranged from 1.9–4.3%. The annual incidence of end-stage renal disease ranged from 0.05–1.5% in T1D and 0.04–1.7% in studies reporting T2D or both types combined.

Conclusions: The annual incidence of microalbuminuria and albuminuria is approximately 2–3% in T1D, and about 8% in T2D. The incidence of developing eGFR<60 ml/min/1.73m² is approximately 2–4% per year. Despite the wide variation in methods and study design, within a particular category of kidney disease, there was only modest variation in incidence rates. These findings provide data that can be used for clinical and public health risk prediction, as well as for the design of clinical trials.