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Type 2 diabetes and CKD| Episode 4: How does chronic kidney disease progress?

Did you know that approximately 40% of people living with type 2 diabetes develop chronic kidney disease, or CKD1? Let’s learn more about exactly how CKD develops and how you can look after your kidneys in the episode below.

What is CKD?

CKD occurs when there is persistent damage to the kidneys for at least 3 months, which can cause them to slowly stop working properly2,3. The term “chronic” explains the long duration of the disease.

This damage to the kidneys can occur from inflammation due to chronically high blood sugar levels, which damages the network of blood vessels and tubules inside the kidneys4. Therefore, it is common for CKD to develop in people with type 2 diabetes. This being said, people with obesity are also at higher risk5

CKD is a common disease that can affect people of any age but becomes more prevalent as we get older6. After reaching 40 years of age, the kidneys’ ability to function properly declines each year7.

What are the stages of CKD?

CKD progresses in stages. The damage to the kidneys can start off as mild, leading to mild loss of kidney function3. If the damage continues, CKD can progress to more advanced stages, potentially leading to kidney failure, kidney transplant or the need for dialysis – a treatment that filters the blood3.

CKD is classified based on glomerular filtration rate, known as GFR, which is a measure of kidney function8.

CKD stage8 GFR (ml/min/1.73m²) Kidney function       
G1 >90 Normal or high     
G2 60–89 Mildly decreased
G3a 45–59 Mildly to moderately decreased
G3b 30–44 Moderately to severely decreased
G4 15–29 Severely decreased
G5 <15 Kidney failure

It’s important to understand that not all cases of CKD progress to the most advanced stage. In fact, most people fall into the mild-to-moderate stages, where hospital-based care may not be necessary9-11.

Catching damage to the kidneys as early as possible is key to preventing CKD progression12. Be sure to work with a healthcare professional to closely monitor your kidney health and maintain their function.

Learn more about type 2 diabetes and chronic kidney disease

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References
  1. International Diabetes Federation. IDF Atlas: Diabetes and Kidney Disease Report, 2023. Available at: https://diabetesatlas.org/idfawp/resource-files/2023/11/IDF1040-Atlas-Diabetes-and-Kidney-Disease-Report-V4.pdf Last accessed: January 2025.
  2. Kalantar-Zadeh K, Jafar TH, Nitsch D, et al. Chronic kidney disease. Lancet. 2021;398:786-802.
  3. Evans M, Lewis RD, Morgan AR, et al. A Narrative Review of Chronic Kidney Disease in Clinical Practice: Current Challenges and Future Perspectives. Adv Ther. 2022;39:33-43.
  4. Wu T, Ding L, Andoh V, et al. The Mechanism of Hyperglycemia-Induced Renal Cell Injury in Diabetic Nephropathy Disease: An Update. Life (Basel). 2023;13.
  5. Nawaz S, Chinnadurai R, Al-Chalabi S, et al. Obesity and chronic kidney disease: A current review. Obes Sci Pract. 2023;9:61-74.
  6. Harvard Health Publishing. Chronic kidney disease: What to know about this common, serious condition. Available at: https://www.health.harvard.edu/diseases-and-conditions/chronic-kidney-disease-what-to-know-about-this-common-serious-condition Last accessed: January 2025. 
  7. Guppy M, Thomas ET, Glasziou P, et al. Rate of decline in kidney function with age: a systematic review. BMJ Open. 2024;14:e089783.
  8. Kidney Disease: Improving Global Outcomes CKDWG. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105:S117-S314.
  9. Wu B, Bell K, Stanford A, et al. Understanding CKD among patients with T2DM: prevalence, temporal trends, and treatment patterns-NHANES 2007-2012. BMJ Open Diabetes Res Care. 2016;4:e000154.
  10. Cleveland Clinic. Chronic Kidney Disease. Available at: https://my.clevelandclinic.org/health/diseases/15096-chronic-kidney-disease Last accessed: January 2025 
  11. Kidney Research UK. Chronic Kidney Disease. Available at: https://www.kidneyresearchuk.org/conditions-symptoms/chronic-kidney-disease/ Last accessed: January 2025.
  12. Kushner P, Khunti K, Cebrian A, et al. Early Identification and Management of Chronic Kidney Disease: A Narrative Review of the Crucial Role of Primary Care Practitioners. Adv Ther. 2024;41:3757-3770.