Diabetic kidney disease may be more common than currently assumed according to new research presented at ASN Kidney Week 2014. A study of 150 deceased individuals with diabetes found nearly 50% had diabetic nephropathy at their time of death.

Researchers at the Leiden University Medical Center in The Netherlands performed an autopsy study to more accurately determine the rates of diabetic kidney disease. They collected kidney tissue samples from 150 deceased individuals with a confirmed diabetes diagnosis during their lives. Using light and/or electron microscopy they were able to identify individuals with kidney disease and then grade its severity.

“Our findings show a histologically proven diabetic nephropathy in much more patients than would have been estimated clinically,” said lead author Celine Klessens. The researchers also noted non-significant trends for association between the severity of diabetic kidney disease and death due to cardiovascular disease (p = 0.059) and duration of diabetes diagnosis (p = 0.07).

“Some of these patients had clinical evidence of diabetic nephropathy during their lives, others did not,” Klessens added. “Only 3 out of 150 patients underwent a renal biopsy during their lifetimes.”

Klessens noted that there is no cure yet for diabetic kidney disease. “Closely monitoring patients with diabetes, e.g. by searching for proteinuria, would be helpful in establishing the diagnosis of diabetic nephropathy as soon as possible. To develop therapeutic measurement in order to control or even reverse the renal lesions is the next challenge,” she noted.

“Diabetic Nephropathy Underdiagnosed: Results from an Autopsy Study” (Abstract SA-PO273)