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Updated: Jun 7, 2025

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Prediabetes and CKD: Does a causal relationship exist.

Jorge Rico Fontalvo1, María José Soler2, Rodrigo Daza Arnedo3

  • 1Asociación Colombiana de Nefrología e HTA, Bogotá, Colombia; Facultad de Medicina, Departamento de Nefrología, Universidad Simón Bolívar, Barranquilla, Colombia.

Nefrologia
|November 15, 2024
PubMed
Summary

Prediabetes and insulin resistance may contribute to chronic kidney disease (CKD) development through inflammation and neurohormonal pathways, even before diabetes onset. Further research is needed to clarify this link and potential treatments.

Keywords:
AlbuminuriaChronic kidney diseaseEnfermedad renal crónicaHiperglicemiaHyperglycemiaPrediabetes

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Area of Science:

  • Nephrology
  • Endocrinology
  • Metabolic Diseases

Background:

  • The link between diabetes and kidney disease is established, but prediabetes's role is less understood.
  • Lack of standardized definitions and inconsistent study data contribute to the knowledge gap.
  • Inflammation and neurohormonal factors in prediabetes may precede diabetes and drive kidney damage.

Purpose of the Study:

  • To review existing evidence on the association between prediabetes and chronic kidney disease (CKD) development.
  • To explore potential pathophysiological mechanisms linking prediabetes to kidney dysfunction.
  • To discuss the implications for early intervention and treatment.

Main Methods:

  • Literature review of epidemiological and cohort studies.
  • Analysis of pathophysiological pathways involving inflammation and neurohormonal activation.
  • Synthesis of evidence on prediabetes definitions and kidney function markers.

Main Results:

  • Prediabetes may be associated with glomerular hyperfiltration, albuminuria, and reduced glomerular filtration rate.
  • Inflammation and neurohormonal hyperactivation are potential drivers of kidney damage in prediabetes.
  • Evidence suggests a potential role for existing diabetes medications in managing prediabetes-related kidney issues.

Conclusions:

  • Prediabetes represents a critical window for intervening in kidney disease progression.
  • Further research is warranted to confirm the causal link and optimize therapeutic strategies.
  • Early detection and management of prediabetes are crucial for preventing CKD.