ReviewDiabetes therapy : research, treatment and education of diabetes and related disorders2026
Trajectory of Kidney Function in T1D over Time: A Scoping Review.
Review in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionType 1 diabetes (T1D) is associated with chronic kidney disease (CKD) and major adverse cardiovascular events (MACE). Contemporary data on the natural history of kidney function decline and the effect of therapies on slowing disease progression in T1D-related CKD are limited. We conducted a scoping review to describe the natural trajectory of kidney function and its effects in individuals with T1D in the USA.
methodsIn our scoping review of observational studies and grey literature, we searched EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature [CINAHL; Elton B. Stephens Company (EBSCO)], MEDLINE (Ovid), Scopus (Elsevier), Global Health (Ovid), and the Food and Drug Administration from inception to 25 April 2025. The study population included adults (age ≥ 18 years) with T1D in the USA. Our outcomes were change in estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), MACE (myocardial infarction, ischemic stroke, cardiovascular death, unstable angina, or heart failure hospitalization), and healthcare resource use (HCRU). We screened 6437 abstracts and selected 22 texts that matched our criteria.
resultsIn one cohort, more than 50.0% of individuals with T1D developed moderately increased albuminuria (UACR > 30-299 mg/g) after 20 years and two cohort studies in T1D observed a progressive annual eGFR decline of 3 mL/min/1.73 m
conclusionsT1D is associated with a high burden of CKD, MACE, and healthcare costs. A clearer understanding of the trajectory of kidney function decline in T1D would help providers and policymakers understand the impact potential therapies to treat T1D-related CKD may have on reducing the risk of kidney failure, MACE, and HCRU.
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