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Kidney Week

Abstract: FR-PO0341

Unequal Trajectories: 30-Year Analysis of CKD Attributable to Type 1 Diabetes in the United States, 1990-2021

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Patel, Ishan, Smt. NHL Medical College, Ahmedabad, Gujarat, India
  • Shah, Dhruvil K., Western Reserve Health Education, Warren, Ohio, United States
  • Patel, Zeel, AUC School of Medicine, Cupecoy, Sint Maarten (Dutch part)
  • Ashar, Mili H, Rural Medical College, Loni (Pravara Institute of Medical Sciences), Maharashtra, India
  • Patel, Ker Sureshbhai, Surat Municipal Institute of Medical Education and Research (SMIMER), Surat, India
  • Upadhyay, Devangi, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
  • Patel, Juhi, Gujarat Medical Education and Research Society Medical College & Hospital Valsad, Valsad, India
  • Desai, Hardik Dineshbhai, Gujarat Adani Institute of Medical Sciences, Bhuj, India
  • Amin, Vishrant, Gujarat Medical Education and Research Society Medical College & Hospital Valsad, Valsad, India
Background

Chronic kidney disease (CKD) is a significant long-term complication of Type 1 Diabetes Mellitus (T1DM), yet its evolving burden across age, sex, and geography in the United States remains poorly characterized.

Methods

Trends in age-standardized incidence, mortality, DALYs, and YLDs for CKD due to T1DM were assessed across U.S. states from 1990 to 2021, using annual percentage change (APC) to quantify temporal shifts. Analyses were stratified by age and sex, applying the standardized estimation approach of the Global Burden of Disease 2021 framework.

Results

From 1990 to 2021, APC increased in ASIR by 0.021%, ASMR by 3.25%, ASDALR by 2.28%, and ASYLDsR by 0.48%. The highest APC in ASIR was observed in the District of Columbia (+0.89%) and Mississippi (+0.6%), while ASMR rose most in Oklahoma (+4.72%) and New Mexico (+4.36%). DC was the only region to show a decline in ASMR (−0.11%). Incidence increased most in adults aged ≥55 years (+10%) and 20–54 years (+9%), with corresponding mortality increases of 2.39% and 1.52%, respectively. Females bore a slightly higher burden than males: ASIR (0.2% vs 0.01%), ASMR (1.73% vs 1.75%), and ASDALR (1.08% vs 0.99%).

Conclusion

While incidence has remained largely stable, mortality and DALY rates due to CKD from T1DM are rising—particularly among older adults, women, and states with systemic health disparities. These findings call for urgent, targeted interventions to strengthen early kidney care access, improve diabetes management, and address regional inequalities in CKD outcomes.

Digital Object Identifier (DOI)