Prevalence, Pathophysiology, and Factors Influencing Renal Outcomes in Patients with Type 1 Diabetes: A Systematic Review

Prevalence, Pathophysiology, and Factors Influencing Renal Outcomes in Patients with Type 1 Diabetes: A Systematic Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence, Pathophysiology, and Factors Influencing Renal Outcomes in Patients with Type 1 Diabetes: A Systematic Review Gulmadin Hikmat, Ahsanullah Niazai, Bakht Muhammad, Syed Tayyab Shah, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7057171/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Diabetic kidney disease, which affects up to 40% of those with type 1 diabetes mellitus, significantly increases morbidity and mortality in individuals with type 1 diabetes mellitus. Even with improvements in diabetes treatment, diabetic kidney disease remains a major consequence of chronic hyperglycemia, which damages the kidneys irreversibly. Recent studies emphasize non-albuminuric eGFR decline and acute kidney injury, particularly in children with diabetic ketoacidosis. Ethnic differences significantly complicate the progression of diabetic kidney disease. Objective: The aim is to review recent studies on renal outcomes in type 1 diabetes, with a focus on the incidence of eGFR trajectories, albuminuria evolution, prevalence of CKD, risk factors associated with CKD progression, and the impact of early therapies. Methods: A systematic review that complied with PRISMA 2020 was conducted. Eligible studies were observational studies published in English during the preceding five years that included type 1 diabetes mellitus patients with a diagnosis based on WHO criteria. After screening, ten high-quality studies were selected from the examined databases, including Google Scholar, PMC, and PubMed. The risk of bias was assessed using the NHLBI instrument. Results: Of the 91,296 patients with type 1 diabetes included in the review, 52.64% were male and 47.36% were female. The incidence of albuminuria ranged from 9.8% to 78.9%, and up to 14% of patients had a sharp drop in eGFR. Although it exists, the incidence of end-stage renal disease was comparatively low. Both modifiable risk variables (poor glycemic management, hypertension, dyslipidemia) and non-modifiable ones (diabetic duration, age at onset, and ethnicity) were consistently associated with the advancement of diabetic kidney disease. Conclusion: Diabetic kidney disease is still a serious side effect of type 1 diabetes that calls for better screening and individualised treatment plans. Future studies should improve early intervention strategies, validate predictive biomarkers, and investigate non-albuminuric chronic kidney disease causes. Diabetic kidney disease Type 1 diabetes mellitus Estimated glomerular filtration rate (eGFR) Albuminuria End-stage renal disease Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7057171","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":510183683,"identity":"b651a597-c7c3-48dd-b578-7b30200191c0","order_by":0,"name":"Gulmadin Hikmat","email":"data:image/png;base64,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","orcid":"","institution":"Rokhan Institute of Higher Education","correspondingAuthor":true,"prefix":"","firstName":"Gulmadin","middleName":"","lastName":"Hikmat","suffix":""},{"id":510183684,"identity":"bea46773-c27e-48ab-bd7d-f7f3cfa83dee","order_by":1,"name":"Ahsanullah Niazai","email":"","orcid":"","institution":"Spinghar Institute of Higher Education","correspondingAuthor":false,"prefix":"","firstName":"Ahsanullah","middleName":"","lastName":"Niazai","suffix":""},{"id":510183685,"identity":"b2c3aad0-ebd4-4d72-9ef8-eec975b62b25","order_by":2,"name":"Bakht Muhammad","email":"","orcid":"","institution":"Mayo Hospital Lahore","correspondingAuthor":false,"prefix":"","firstName":"Bakht","middleName":"","lastName":"Muhammad","suffix":""},{"id":510183686,"identity":"e76d91a4-3e31-4d4d-8eaa-11b106888630","order_by":3,"name":"Syed Tayyab Shah","email":"","orcid":"","institution":"Mayo Hospital Lahore","correspondingAuthor":false,"prefix":"","firstName":"Syed","middleName":"Tayyab","lastName":"Shah","suffix":""},{"id":510183687,"identity":"61ca1140-37a8-4312-a4cd-b8fec60244f6","order_by":4,"name":"Mah Rukh Nisar","email":"","orcid":"","institution":"Services Institute of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mah","middleName":"Rukh","lastName":"Nisar","suffix":""}],"badges":[],"createdAt":"2025-07-06 10:08:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7057171/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7057171/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":92417533,"identity":"a7b10eaa-9ce6-4945-a116-ba3d2a1f11d1","added_by":"auto","created_at":"2025-09-29 13:39:09","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":719606,"visible":true,"origin":"","legend":"","description":"","filename":"PrevalencePathophysiologyandFactorsInfluencingRenalOutcomesinPatientswithType1Diabetes.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7057171/v1_covered_380fc4ce-63d6-49a9-a517-80a418276cf2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence, Pathophysiology, and Factors Influencing Renal Outcomes in Patients with Type 1 Diabetes: A Systematic Review","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Diabetic kidney disease, Type 1 diabetes mellitus, Estimated glomerular filtration rate (eGFR), Albuminuria, End-stage renal disease","lastPublishedDoi":"10.21203/rs.3.rs-7057171/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7057171/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Diabetic kidney disease, which affects up to 40% of those with type 1 diabetes mellitus, significantly increases morbidity and mortality in individuals with type 1 diabetes mellitus. Even with improvements in diabetes treatment, diabetic kidney disease remains a major consequence of chronic hyperglycemia, which damages the kidneys irreversibly. Recent studies emphasize non-albuminuric eGFR decline and acute kidney injury, particularly in children with diabetic ketoacidosis. Ethnic differences significantly complicate the progression of diabetic kidney disease. Objective: The aim is to review recent studies on renal outcomes in type 1 diabetes, with a focus on the incidence of eGFR trajectories, albuminuria evolution, prevalence of CKD, risk factors associated with CKD progression, and the impact of early therapies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A systematic review that complied with PRISMA 2020 was conducted. Eligible studies were observational studies published in English during the preceding five years that included type 1 diabetes mellitus patients with a diagnosis based on WHO criteria. After screening, ten high-quality studies were selected from the examined databases, including Google Scholar, PMC, and PubMed. The risk of bias was assessed using the NHLBI instrument.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Of the 91,296 patients with type 1 diabetes included in the review, 52.64% were male and 47.36% were female. The incidence of albuminuria ranged from 9.8% to 78.9%, and up to 14% of patients had a sharp drop in eGFR. Although it exists, the incidence of end-stage renal disease was comparatively low. 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Future studies should improve early intervention strategies, validate predictive biomarkers, and investigate non-albuminuric chronic kidney disease causes.\u003c/p\u003e","manuscriptTitle":"Prevalence, Pathophysiology, and Factors Influencing Renal Outcomes in Patients with Type 1 Diabetes: A Systematic Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-04 18:27:12","doi":"10.21203/rs.3.rs-7057171/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"73788ac9-bf76-4371-baaa-3bc2818e7dba","owner":[],"postedDate":"September 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-29T13:38:36+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-04 18:27:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7057171","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7057171","identity":"rs-7057171","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}