With the aim to determine if kidney damage can be detected in individuals in the pre-diabetic stage, Professor Stephen Atkin, Head of School of Postgraduate Studies and Research at the Royal College of Surgeons in Ireland - Medical University in Bahrain (RCSI Bahrain), in collaboration with international colleagues, recently published a study in PubMed. The study was based on the analysis of results from 20,158 participants in a seven-year (2011-2018) nationally representative cross-sectional survey, published in the National Health and Nutrition Examination Surveys (NHANES) database in the USA.

Led by Professor Atkin, the key aim of this study was to determine if the glycated haemoglobin (HbA1c)-the average blood glucose (sugar) and used in diagnosing diabetes (with a cut off of 6.5%) - reflected in an increase of kidney disease (nephropathy) in individuals with a level of HbA1c less than 6.5%. Diabetic nephropathy can be detected by measuring the level of albumin in urine, defined as a urinary albumin-creatinine ratio (UACR) higher than 30mg/g.

After collecting data and analysing the results from 20,158 participants in the NHANES survey (cycles 7-10 inclusive), the results of the study concluded that the development of kidney disease started earlier than a diagnosis of diabetes. The results also showed that kidney disease started to develop in individuals in the pre-diabetic stage with HbA1c levels ranging from 5.8% to 6.5%. Although a specific cut point for HbA1c levels has not been set for when nephropathy can develop, the study highlights that it starts in prediabetes and its rate increases as you approach a diabetes diagnosis.

Professor Atkin shared his recommendations, “With the high rates of diabetes across the globe, this study highlights the importance of screening for kidney diseases for individuals who are prediabetic. Although the susceptibility may vary with race and other factors, early screening and preventative measures can aid in decreasing the development of the disease.”

This study comes in light of the targets of the Sustainable Development Goal of Good Health and Wellbeing (Goal 3) set out by the United Nations of reducing the mortality rate from non-communicable diseases (chronic diseases such as heart disease, stroke, cancer and diabetes) by one third through prevention, treatment and promoting mental health and well-being.

At RCSI Bahrain, we recognise the importance of constant research to enhance patient care as well as contribute to spreading awareness on preventative measures to improve people’s lives in Bahrain and beyond.