It Goes Both Ways…Kidney Disease Can Also Lead To Diabetes, Study Shows

It is known that a person’s chances of having kidney disease are increased by diabetes. That said, new research by the Washington University School of Medicine in St. Louis has observed that while that statement is true, the inverse is as well. Kidney dysfunction, as it were, increases the chances of having diabetes.

The research also highlighted that a possible culprit of the 2-way relationship between diabetes and kidney disease is urea. It is the breakdown of protein foods that brings about this nitrogen-containing waste product in the blood.

This discovery is important because the urea levels can be significantly reduced with the aid of diet and medication and thus, enabling better treatment and possibly, a reduced risk of diabetes. This study, which was conducted in collaboration with the Veterans Affairs St. Louis Health Care System, was published in Kidney International on the 11th of December.

Ziyad Al-Aly, MD and an assistant professor at the Washington University noted in this research publication that it has been known for a while that diabetes is a crucial risk factor for kidney disease however, a clearer understanding that kidney disease increases the risk of diabetes through elevated levels of urea was established by the research. Impaired insulin secretion as well as increased insulin resistance occurs when urea builds up in the blood because of kidney dysfunction.

Washington University researchers, in collaboration with scientists at the St. Louis Veterans Affairs’ Clinical Epidemiology Center examined the medical records in national VA database to explore the relationship between diabetes and kidney disease. The research covered a population sample f 1.3 million adults over a 5-year periods starting from 2003.

From the common blood test that reveals the urea levels in the blood stream showed that 1117,000 of those that don’t have diabetes – or 9% – had increase urea levels, which was a sign of poor kidney function. That statistic was pretty consistent over time as noted by Al-Aly. These figures could apply to the general populace.

Generally, he observed that there was a 23% higher chance for people with high urea levels to get diabetic. Comparing risk between people with high and low urea levels arrived at this statistic. For every year that was considered, the researchers were able to record new cases of diabetes in 2,989 people out of every 100,000 that had low urea levels while for people with high urea levels, 3,677 new cases of diabetes were recorded for every 100,000.

Al-Aly noted that a risk difference per 100,000 people examined was 688 and this means that 688 more people with high urea levels were recorded from every 100,000 people.

Al-Aly stated that it was after reading a mouse study published in August 2016 Journal of Clinical Investigation that he was inspired to delve into the relationship between kidney disease and diabetes. For the sake of research, kidney failure was induced in mice by the researchers from the University of Montreal Hospital Research Centre in Canada. After which majority of the animals witnesses heightened levels of urea in their bloodstream, leading to impaired insulin secretion and insulin resistance.

Al-Aly recalled that he found the study exciting and intriguing while reading it and that was when he knew he had to do similar research in humans. The results were almost identical to that of the mouse study and a clear relationship between risk of diabetes and urea levels was established.

This only serves to cement the need for healthy diet and exercise in kidney disease sufferers even further.