September 23, 2026

Progression of early kidney injury in youth with type 2 diabetes: A follow-up analysis from the canadian iCARE cohort

Youth with type 2 diabetes (T2D) are at increased risk of having kidney disease, or developing it later in life. In a recent study, researchers assessed the kidney health of youth with T2D at two- and four-year intervals, showing that many had kidney damage that continued or worsened over the course of the study.

While kidney disease and diabetes are complications that commonly occur together, the development of T2D in youth is associated with more severe kidney disease and a faster decline in kidney function compared to people who develop diabetes later in life.

To better understand how kidney damage progresses in youth with T2D, Anna Liu and her colleagues at the University of Manitoba analyzed health date from 188 youth from the iCARE (improving renal Complications in Adolescents with type 2 diabetes through Research) study with follow-up over the course of several years. Specifically, the researchers looked at test results for albuminuria, which is often the first indication of kidney damage in youth with T2D.

At the beginning of the study, 27% had albuminuria levels indicating kidney damage. After two years, 59% had normal urine albumin levels, 10% improved, 15% persisted, and 17% progressed.

Youth who had consistent evidence of kidney damage over time tended to have higher blood sugar levels and were more likely to be taking a type of medication called an ACE inhibitor, which is used to control blood pressure and reduce urine protein loss. The youth who were more likely to experience worsening kidney damage tended to have T2D for a longer duration.

The researchers note that that this study included predominantly First Nations and Métis youth.  The higher risk of early and progressive kidney damage compared to youth with diabetes in other studies may be due to ongoing impacts of colonization. Indigenous youth also have disproportionately higher rates of poverty, isolation, and food insecurity, which may contribute to these worse health outcomes.

The researchers also assessed mental health scores in this study, given how past studies have found a correlation between worsening kidney damage and mental health. They found that 17.2% of the study participants had significant distress and 54.6% significant stress. While mental health scores did not worsen as youth experienced higher albuminuria levels (and thus kidney damage), the researchers caution that the study participants were not followed for a very long time, and mental health in this population should be studied more closely in future studies.