The combination of high diabetes prevalence, declining mortality trends and high chronic kidney disease (CKD) prevalence has raised concerns about the future burden of CKD in the American Indian population. We modeled the future prevalence of diabetes and CKD in a Southwestern American Indian population well-characterized for type 2 diabetes using data from research examinations conducted on 4,476 participants between 1965 and 2007. Diabetes was assessed by 2-hour glucose tolerance testing, CKD was defined by estimated GFR (eGFR) <60 ml/min/1.72 m2. Estimates of age-specific prevalence of diabetes without CKD (p1) and with CKD (p2) were projected through 2030, using illness-death models of the observed prevalence, incidence and death rates for men and women (Figure). For women 40 years old, p1 is projected to decline from 42.2% in 2010 to 17.1% in 2030, whereas p2 is projected to increase from 3.3% to 34.9% in the same decades. Among 40 year-old men, p1 is projected to decline from 42.3% in 2010 to 29.8% in 2030, concurrent with an increase in p2 from 3.4% in 2010 to 8.2% in 2030. Similar trends were observed for older ages, whereas for those younger than 40 years, the increase in p2 was most prominent among women.

In conclusion, the model provides assessment of the future burden of diabetes and diabetes-related CKD, projecting a marked increase in the proportion of people with diabetes who will have CKD over the next two decades.


M.E. Pavkov: None. A. Hoyer: None. E.W. Gregg: None. R. Brinks: None. P.H. Bennett: None.

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