ReviewKidney international2017
Fast renal decline to end-stage renal disease: an unrecognized feature of nephropathy in diabetes.
Review in Kidney international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
123 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Prediction models for progression from diabetic kidney disease to end-stage renal disease: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Is eGFR Slope a Novel Predictor of Chronic Complications of Type 2 Diabetes Mellitus? A Systematic Review and Meta-Analysis.Journal of diabetes research · 2024Pooled it
- Pooled it
- The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).Hypertension research : official journal of the Japanese Society of Hypertension · 2019Guideline
- Chinese herbal medicine for diabetic kidney disease: a systematic review and meta-analysis of randomised placebo-controlled trials.BMJ open · 2019Pooled it
- Dapagliflozin and Prevention of Kidney Disease Among Patients With Type 2 Diabetes: Post Hoc Analyses From the DECLARE-TIMI 58 Trial.Diabetes care · 2022Trial
- Effects of Selonsertib in Patients with Diabetic Kidney Disease.Journal of the American Society of Nephrology : JASN · 2019Trial
- Aging-driven transcriptional programs in diabetic kidney disease: multi-omics discovery of diagnostic biomarkers and drug-repurposing targets.Clinical epigenetics · 2026Article
- The impact of blood pressure variability and African Caribbean ethnicity on the progression of diabetic kidney disease in type 1 diabetes.Diabetologia · 2026Article
- Heterogeneous Kidney Patterns in Diabetic Patients Following SGLT2 Inhibitor Use.Journal of Korean medical science · 2026Article
- Heterogeneity of Estimated GFR Slopes According to Etiology, Estimated GFR and Urinary Albumin-to-Creatinine Ratio in a Large Cohort of Patients With CKD.Kidney international reports · 2026Article
- Risk factors for persistent decline in eGFR of Japanese patients with diabetes: Analysis using a large-scale diabetes registry J-DREAMS.Journal of diabetes investigation · 2026Article
- Longitudinal evaluation of glomerular filtration rate across adolescence and early adulthood in youth with type 1 diabetes: associations with clinical and social risk factors.Frontiers in endocrinology · 2026Article
- Proteinuria in Deceased Diabetic Donors and Kidney Transplant Outcomes.Canadian journal of kidney health and disease · 2026Article
- Metabolic phenotype dimensions and longitudinal renal function in type 2 diabetes: a principal component analysis-based approach with UACR integration.Frontiers in endocrinology · 2026Article
- A Narrative Review of Stem Cell-Derived Exosomes for Diabetic Nephropathy.Stem cells international · 2026Review
- Baseline and long-term frailty transitions and rapid estimated glomerular filtration rate decline: evidence from two large population-based studies.Renal failure · 2025Article
- Observational
- Estimated Glomerular Filtration Rate Variability in Patients with Diabetes Receiving SGLT2 Inhibitors Versus DPP4 Inhibitors.Pharmaceutics · 2025Article
- Branched-chain amino acids contribute to diabetic kidney disease progression via PKM2-mediated podocyte metabolic reprogramming and apoptosis.Nature communications · 2025Article
63 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
A new model of diabetic nephropathy in type 1 diabetes emerged from our studies of Joslin Clinic patients. The dominant feature is progressive renal decline, not albuminuria. This decline is a unidirectional process commencing while patients have normal renal function and, in the majority, progressing steadily (linearly) to end-stage renal disease (ESRD). While an individual's rate of renal decline is constant, the estimated glomerular filtration rate (eGFR) slope varies widely among individuals from -72 to -3.0 ml/min/year. Kidney Disease: Improving Global Outcomes guidelines define rapid progression as rate of eGFR declines > 5 ml/min/year, a value exceeded by 80% of patients in Joslin's type 1 diabetes ESRD cohort. The extraordinary range of slopes within the rapid progression category prompted us to partition it into "very fast," "fast" and "moderate" decline. We showed, for the first time, that very fast and fast decline from normal eGFR to ESRD within 2 to 10 years constitutes 50% of the Joslin cohort. In this review we present data about frequency of fast decliners in both diabetes types, survey some mechanisms underlying fast renal decline, discuss methods of identifying patients at risk and comment on the need for effective therapeutic interventions. Whether the initiating mechanism of fast renal decline affects glomerulus, tubule, interstitium or vasculature is unknown. Since no animal model mimics progressive renal decline, studies in humans are needed. Prospective studies searching for markers predictive of the rate of renal decline yield findings that may make detection of fast decliners feasible. Identifying such patients will be the foundation for developing effective individualized methods to prevent or delay onset of ESRD in diabetes.
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