Kidney disease of diabetes mellitus: NIDDK initiatives for the comprehensive study of its natural history, pathogenesis, and prevention.

Kidney disease of diabetes mellitus (KDDM) is the most common single cause of end-stage renal disease in the United States and western Europe. Diabetic patients have increased morbidity and mortality and are more likely to develop renal failure than the general US population. In addition, the 5-year survival of patients with KDDM who are receiving dialytic therapy is less than one-half that of patients without diabetes mellitus. The National Institute of Diabetes and Digestive and Kidney Diseases, in collaboration with public, private, and academic groups, has developed an implementation plan to enhance understanding of the underlying mechanisms in KDDM and to develop strategies to prevent the onset and the progression of KDDM.