Diabetic Nephropathy Epidemiology Forecast Insight

DelveInsight’s ‘Diabetic Nephropathy – Epidemiology Forecast – 2030’ report delivers an in-depth understanding of the historical and forecasted epidemiology of Diabetic Nephropathy in the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan.

Geography Covered

• The United States
• EU5 (Germany, France, Italy, Spain, and the United Kingdom)
• Japan

Study Period: 2018–2030

Diabetic Nephropathy: Disease Understanding

Diabetic Nephropathy Overview

Diabetic nephropathy (DN), also known as diabetic kidney disease (DKD), is a clinical syndrome characterized by persistent albuminuria and a progressive decline in renal function, and the term infers the presence of a typical pattern of glomerular disease. Diabetic nephropathy is usually associated with arterial hypertension and increased cardiovascular morbidity and mortality; outcomes for people with type 1 (T1DM) or type 2 (T2DM) diabetes who develop diabetic nephropathy are significantly worse than those who do not.

Diabetic nephropathy is classified into five stages: Stage 1, Stage 2, Stage 3, Stage 4, and Stage 5. These five stages are described as follows: Stage 1 or normoalbuminuria stage, showing normal kidney function or increased estimated glomerular filtration rate (eGFR), of more than 30 mL/min; Stage 2 or microalbuminuric stage, showing microalbuminuria with 30–299 mg/g Cr of urinary albumin excretion (UAE) and Egfr of 30 mL/min; Stage 3 or macroalbuminuric stage, showing macroalbuminuria >300 mg/g Cr of UAE and eGFR of >30 mL/min; Stage 4 or renal failure stage, showing a decline in renal function with eGFR <30 mL/min; and Stage 5 or kidney failure, which is the dialysis stage.

In many cases, diabetic nephropathy is a clinical diagnosis. A kidney biopsy is the gold standard test for diagnostic and prognostic information, but in most centers, it is usually only performed when an alternative renal pathology is suspected. Also, diabetic nephropathy usually does not cause symptoms, so guidelines from the ADA and KDIGO group recommend that all people with diabetes should have a renal function and albuminuria measured at diagnosis and annually thereafter in T2DM; in T1DM, this can start from 5 years after diagnosis. Albuminuria is best assessed using ACR measurements on spot urine samples (ideally early morning samples); timed or 24-h urine collections to measure albumin excretion are also appropriate, although less convenient and more prone to collection errors. Renal function should be assessed using a serum-creatinine-based eGFR calculation (CKD-EPI equation recommended due to its superior performance in the eGFR range 60–90 mL/min/1.73 m2).

Current management strategies employ aggressive glycemic and blood pressure control combined with renin–angiotensin–aldosterone system-blocking agents to slow the worsening of kidney disease. However, this approach nonetheless results in significant residual renal and cardiovascular risk. In addition, people with DKD are also more likely to experience retinopathy, neuropathy, and foot ulcers, so increased vigilance for these complications is important.

BP should be controlled with drugs that reduce cardiovascular events (angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, thiazide-like diuretics, or calcium channel blockers). Mineralocorticoid receptor antagonists (MRA) are also considered in hypertensive management. The first oral MRA was spironolactone followed by Eplerenone; both are steroidal MRA. These drugs are often used off-label in type 2 DM patients with mild-to-moderate arterial hypertension and albuminuria.

Improving glycemic control has beneficial effects on the development and progression of DN. The recently introduced selective sodium-glucose cotransporter type 2 (SGLT2) inhibitors improve glycemic control in an insulin-independent manner by blocking glucose reabsorption in the renal-proximal tubule, thereby enhancing urinary glucose excretion. However, the use of SGLT2i is still limited by the high cost and regulatory contraindications for patients with eGFR <60 mL/min/1.73 m2. Some GLP-1RA, including liraglutide, semaglutide, and dulaglutide, have also shown renal benefits, and contrary to SGLT2i, can currently be administered up to an eGFR of 15 mL/min/1.73 m2. Besides, Sulfonylureas are also used for glycemic control. However, first-generation sulfonylureas are rarely prescribed. The second-generation sulfonylureas, which include glipizide, glimepiride, glyburide, and gliclazide (the latter is not available in the US), are commonly used. Nevertheless, sulfonylureas and their metabolites are renally cleared, leading to an increased risk of hypoglycemia as GFR declines. Other hypoglycemic agents with potential benefit in DKD are dipeptidyl peptidase 4 (DPP4) inhibitors, but further research needs to be conducted. The commonly used DPP4 inhibitors include sitagliptin, saxagliptin, linagliptin, and alogliptin.

To conclude, effective delivery of these interventions in combination reduces the risks of DKD progression, as well as other microvascular complications, cardiovascular events, and mortality. However, the current management of DKD still leaves a substantial residual risk for kidney disease progression, morbidity, and mortality.

Diabetic Nephropathy: Epidemiology

The Diabetic Nephropathy epidemiology division provides insights into the historical and current patient pool, along with the forecasted trend for every seven major countries. It helps recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the report also provides the diagnosed patient pool, trends, and assumptions.

Key Findings

The disease epidemiology covered in the report provides historical and forecasted Diabetic Nephropathy epidemiology segmented as Prevalence of Diabetic Nephropathy, Age-specific cases of Diabetic Nephropathy, Gender-specific cases of Diabetic Nephropathy, Stage-specific cases of Diabetic Nephropathy. The report includes the prevalent scenario of Diabetic Nephropathy in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2018 to 2030.

Country-wise Diabetic Nephropathy Epidemiology

The epidemiology segment also provides the Diabetic Nephropathy epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

• The prevalent population of Diabetic Nephropathy in the 7MM countries was estimated to be 27,634,000 cases in 2020.
• As per the estimates, the United States had the largest prevalence of Diabetic Nephropathy in 2020. Among the EU5 countries, Germany had the largest prevalent population of Diabetic Nephropathy with 5,232,291 cases, followed by Spain in 2020. On the other hand, Italy had the lowest prevalent population of 1,036,924 cases in 2020.

Scope of the Report

• Diabetic Nephropathy report covers a detailed overview explaining its causes, symptoms, classification, pathophysiology, diagnosis, and treatment patterns.
• Diabetic Nephropathy Epidemiology Report and Model provide an overview of the risk factors and global Diabetic Nephropathy trends in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan).
• The report provides insight into the historical and forecasted patient pool of Diabetic Nephropathy in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan.
• The report helps recognize the growth opportunities in the 7MM concerning the patient population.
• The report assesses the disease risk and burden and highlights the unmet needs of Diabetic Nephropathy.
• The report provides the segmentation of the Diabetic Nephropathy epidemiology by prevalent cases of Diabetic Nephropathy in the 7MM.
• The report provides the segmentation of the Diabetic Nephropathy epidemiology by the age-specific cases of Diabetic Nephropathy in the 7MM.
• The report provides the segmentation of the Diabetic Nephropathy epidemiology by the gender-specific cases of Diabetic Nephropathy.
• The report provides the segmentation of the Diabetic Nephropathy epidemiology by stage-specific cases of Diabetic Nephropathy in the 7MM.

Report Highlights

• 10-year Forecast of Diabetic Nephropathy epidemiology.
• 7MM Coverage.
• Prevalence of Diabetic Nephropathy
• Age-specific cases of Diabetic Nephropathy
• Gender-specific cases of Diabetic Nephropathy
• Stage-specific cases of Diabetic Nephropathy

KOL Views

We interview KOLs and obtain SME’s opinions through primary research to fill the data gaps and validate our secondary research. The opinion helps understand the total patient population and current treatment pattern. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the indications.

Key Questions Answered

• What will be the growth opportunities in the 7MM for the patient population pertaining to Diabetic Nephropathy?
• What are the key findings pertaining to the Diabetic Nephropathy epidemiology across 7MM, and which country will have the highest number of patients during the forecast period (2018–2030)?
• What would be the total number of patients with Diabetic Nephropathy across the 7MM during the forecast period (2018–2030)?
• Among the EU5 countries, which country will have the highest number of patients during the forecast period (2018–2030)?
• At what CAGR the patient population is expected to grow by 7MM during the forecast period (2018–2030)?
• What are the disease risk, burdens, and unmet needs of Diabetic Nephropathy?
• What are the currently available treatments for Diabetic Nephropathy?

Reasons to buy

Diabetic Nephropathy Epidemiology report will allow the user to:

• Develop business strategies by understanding the trends shaping and driving the global Diabetic Nephropathy market
• Quantify patient populations in the global Diabetic Nephropathy market to improve product design, pricing, and launch plans
• Organize sales and marketing efforts by identifying the age groups and sex that present the best opportunities for Diabetic Nephropathy therapeutics in each of the markets covered
• Understand the magnitude of the Diabetic Nephropathy population by its prevalent cases of Diabetic Nephropathy.
• Understand the magnitude of the Diabetic Nephropathy population by its gender-specific cases of Diabetic Nephropathy.
• Understand the magnitude of the Diabetic Nephropathy population by its age-specific cases of Diabetic Nephropathy.
• Understand the magnitude of the Diabetic Nephropathy population by its stage-specific cases of Diabetic Nephropathy.
• The Diabetic Nephropathy epidemiology report and model were written and developed by Masters and PhD level epidemiologists.
• The Diabetic Nephropathy Epidemiology Model developed by DelveInsight is easy to navigate, interactive with dashboards, and epidemiology based on transparent and consistent methodologies. Moreover, the model supports data presented in the report and showcases disease trends over a 10-year forecast period using reputable sources.

Key Assessments

• Patient Segmentation
• Disease Risk and Burden
• Risk of disease by the segmentation
• Factors driving growth in a specific patient population