Results from a study by researchers at Washington University School of Medicine in St. Louis indicate patients with kidney disease may also develop diabetes if progression toward kidney failure is not addressed.

“We have known for a long time that diabetes is a major risk factor for kidney disease, but now we have a better understanding that kidney disease, through elevated levels of urea, also raises the risk of diabetes,” senior author of the study Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University, said in a press release. “When urea builds up in the blood because of kidney dysfunction, increased insulin resistance and impaired insulin secretion often result.”

Washington University researchers collaborated with scientists at the St. Louis Veterans Affairs’ Clinical Epidemiology Center to examine the medical records of 1.3 million adults without diabetes during a 5-year period.

More than 117,000 of those individuals without diabetes — or 9% — showed elevated urea levels in blood urea nitrogen tests.

“That figure — 9% of people with high urea levels — remained relatively constant over time,” Al-Aly said.

Based on that number, the researchers determined that the high urea levels posed a 23% higher risk of diabetes after comparing risk between those with high and low urea levels. In each year studied, researchers documented new cases of diabetes in 2,989 of every 100,000 people with low urea levels and 3,677 new cases of diabetes among those with high urea levels.

“The risk difference between high and low levels is 688 cases of diabetes per 100,000 people each year,” Al-Aly said. “This means that for every 100,000 people, there would be 688 more cases of diabetes each year in those with higher urea levels.” – by Mark E. Neumann

Yan X, et al. Kidney International. 2017;doi: