Avellon Williams
LONDON, UNITED KINGDOM- People with type 1 diabetes have a higher risk of developing kidney disease based on their ethnicity for the first time, new research confirms.
Researchers from King’s College London have published one of the largest studies of its kind in Diabetes Care. Those with African-Caribbean heritage and diabetes have a 60% increased risk of advanced kidney disease, according to the study.
An autoimmune condition, type 1 diabetes can cause symptoms as early as childhood. Lifestyle factors are often responsible for type 2 diabetes and it can develop over time. The number of people living with type 1 diabetes in the UK is estimated at 400,000, with 10% of those people having the condition. The prevalence of kidney disease among diabetics varies by type, but it affects nearly 30-40% of people with diabetes.
Even though ethnicity is a risk factor for type 2 diabetes as well as kidney disease, little is known about whether ethnicity is a risk factor for kidney complications associated with type 1 diabetes. Previous studies on kidney disease risk factors have been conducted on cohorts that were more homogeneous and predominantly Caucasian.
In a study from King’s College London, more than 5,000 people with type 1 diabetes were examined. Among this cohort, 13% were African-Caribbean and all had good kidney function. Following eight years of follow-up, they observed that 260 people had a decline of more than 50% in kidney function and developed stage 4 kidney disease, which is an indicator of severe and advanced kidney disease. A kidney transplant or dialysis is often needed to survive stage 5 kidney failure.
Findings show despite other known kidney disease risk factors like blood pressure and glucose control, African-Caribbean people appear to have an elevated risk of kidney disease.
The lead author of the study, Dr. Janaka Karalliedde of King’s College London, says “diabetic kidney failure is devastating for those affected and their families. For the first time, ethnicity has been evaluated in kidney function loss associated with type 1 diabetes. People living with type 1 diabetes who are African-Caribbean have a 60% higher risk of losing more than half their kidney function. This loss also occurs faster in African – Caribbeans. Studying and understanding the exact reasons for this increased risk of kidney disease in African-Caribbean people with type 1 diabetes requires further research.”
According to Hilary Nathan, Director of Policy and Communications at JDRF UK, “this study shows that people of African-Caribbean heritage have a higher risk of kidney disease due to type 1 diabetes. For people with type 1 diabetes from African-Caribbean backgrounds, traumatic kidney failure needs to be addressed with greater funding and focus, so that they don’t have to face undue fear or consequences. Several research grants were provided by Guy’s and St Thomas Hospital Charity for this study.”
It was in 2013 that Daniel Newman, 36, from London, “was diagnosed with chronic kidney disease due to type 1 diabetes. In early 2017, he said his kidney function dropped to 20%, making it difficult to manage the disease. It was a dreadful experience seeing my consultant because if my function decreased, I was closer to requiring dialysis or a transplant. I knew my African-Caribbean heritage would put me at a disadvantage when it came to transplantation. As luck would have it, I received a kidney transplant in 2018, however, I was only weeks away from needing dialysis. My understanding of why I developed the disease has been greatly enhanced by this study.”
