Vnitr Lek 2025, 71(2):E13-E18 | DOI: 10.36290/vnl.2025.024

The rate of progression of diabetic kidney disease in patients with type 1 diabetes mellitus

Lucia Bučková¹, Miroslava Horáčková¹, Petr Hoffmann¹, Michala Lustigová^{2, 3}, Monika Tothová^{1, 4}, Marika Koželuhová¹, Ondřej Pátek¹, Jan Brož¹

¹ Interní klinika 3. LF UK a FNKV, Praha

² Státní zdravotní ústav, Praha

³ PřF UK, Praha

⁴ Fresenius Medical Care - DS, Praha

The risk of developing diabetic nephropathy is directly proportional to the duration of type 1 diabetes, with metabolic control of the disease playing a crucial role. The peak incidence of diabetic nephropathy occurs between 10 and 20 years after the diagnosis of the underlying disease. The annual incidence of albuminuria development in patients with type 1 diabetes mellitus is 2-3%. The annual incidence of a decline in estimated glomerular filtration rate below 60 ml/min/1.73 m² is 2-4 %, regardless of the type of diabetes. According to older studies from the late 1980s, an individual with type 1 diabetes mellitus (DMT1) has a 40% chance of developing proteinuria over 40 years of diabetes duration. More recent cross-sectional studies from several national registries indicate that 8 % of type 1 diabetics with a diabetes duration of less than 20 years develop microalbuminuria, and nearly 25 % do so after more than 40 years of diabetes. Despite the use of modern therapeutic approaches in diabetes treatment, a significant proportion of individuals with DMT1 develop renal complications in the form of albuminuria or impaired glomerular filtration within less than 20 years after diagnosis. Although the preservation of kidney function after the onset of proteinuria has also improved, it remains much worse compared to individuals with DMT1 without albuminuria. There is a lack of studies in the available literature that adequately describe the rate of development of diabetic kidney disease from the time of diabetes diagnosis.

Keywords: diabetes mellitus, diabetic kidney disease, albuminuria, glycated hemoglobin.

Accepted: March 18, 2025; Published: March 27, 2025  Show citation