Diabetes is a significant risk factor for kidney function decline, as those with diagnosed diabetes likely to decline nearly twice as rapidly as those without diabetes, a recent study found. Researchers classified 15,517 participants in the community-based Atherosclerosis Risk in Communities (ARIC) study by diabetes status at baseline (1987-1989; no diabetes, undiagnosed diabetes, and diagnosed diabetes). They then used linear mixed models with random intercepts and slopes to quantify estimated glomerular filtration rate (eGFR) trajectories at 4 visits over 26 years. Among the findings:

• Adjusted mean eGFR decline over the full study period among those without diabetes was ‒1.4 mL/min/1.73 m²/year; with undiagnosed diabetes was ‒1.8 mL/min/1.73 m²/year; and with diagnosed diabetes was ‒2.5 mL/min/1.73 m²/year.
• Among those with diagnosed diabetes, steeper declines were seen in those with modifiable risk factors, including hypertension and glycemic control.
• Among those with diagnosed diabetes, risk factors for steeper eGRF decline also included African American race and APOL1 high-risk genotype.