UC HEALTH LINE: Multidisciplinary Team Focuses on Preventing Diabetic Kidney Failure

Cincinnati—Kidney specialists at the University of Cincinnati (UC) say a collaborative approach to care that includes early intervention can help prevent kidney failure in diabetes patients.

Nephrologists Janet Boyle, MD, and Kotagal Kant, MD, are working with the multidisciplinary team at the UC Diabetes Center to identify people at high risk for chronic kidney disease. Their goal is to implement early-intervention medical treatments that will help postpone disease onset.

“Diabetics are more prone to develop renal disease because their kidneys’ ability to filter harmful substances from the blood is already severely impaired,” says Boyle, assistant professor of medicine at UC. “The idea is to catch and begin treating kidney problems as soon as possible—in the early stages of disease—so we can prolong kidney function and give patients a better quality of life.”

Located near the middle of the back, kidneys are bean-shaped organs that keep the body’s blood supply clean and chemically balanced by filtering out waste products and excess water.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) estimates that more than 8 million adults have chronic kidney disease. This condition, which causes gradual loss of kidney function, can be “silent” for many years prior to diagnosis. Patients with it are at increased risk of dying from a stroke or heart attack.

Kant and Boyle believe a proactive, multidisciplinary approach to diabetic care that involves nephrologists, diabetes specialists and nurse educators can slow the progression of—and possibly even eliminate—chronic kidney disease in people with diabetes.

Research has shown that early diagnosis and careful control of blood glucose (sugar) levels and blood pressure, combined with certain medications used to control diabetes, can lessen the severity of kidney disease for diabetic patients.

“If we can prescribe the right balance of medications to manage high blood pressure and reduce the amount of protein in their urine,” adds Boyle, “we can preserve kidney function and help diabetes patients live longer.”

Kant estimates that more than 1 million people will receive regular dialysis (a medical blood-filtering process) to treat chronic kidney disease by 2010. If their condition is left unchecked, he says, most diabetic patients will develop chronic kidney disease within several years of diagnosis.

“But with strategic medical management of the disease,” adds Kant, “we may be able to eliminate the need for dialysis in people with chronic kidney disease. That would help reduce health care costs and improve the lives of thousands of people.”

According to the American Diabetes Association (ADA), more than $92 million is spent in the United States each year on direct medical costs associated with diabetes, and more than 153,000 people are living on chronic dialysis or a kidney transplant due to diabetes-related kidney disease.

Physicians stress that there are no definitive signs of chronic kidney disease, but people with diabetes and high blood pressure are at greatest risk.

To schedule an appointment with Boyle or Kant at the UC Diabetes Center, call (513) 475-8200.