Is there really good news about pandemic diabetic nephropathy?

Defined in the dictionary as an adjective, the word pandemic, meaning: ‘occurring over a wide geographic area and affecting an exceptionally high proportion of the population,’ like epidemic, has evolved to its current usage as a noun [1]. In 2005, growth in number of individuals in the United States treated for end-stage renal disease (ESRD) was analysed using data generated by the United States Renal Data system (USRDS), sustaining the conclusion that most of the expansion ‘was due to a three-fold increase in risk of ESRD in people with diabetes and therefore, qualifies as an epidemic (Figure 1) [2].’ Examination of the epidemic growth curve of diabetes [3] pointed to diabetes mellitus as the leading cause of ESRD (i.e. kidney failure requiring dialysis or transplantation) in the United States, accounting for 44% of new cases of treated ESRD in 2002 [4]. As depicted in Figure 2, the incidence count of new ESRD patients between 1984 and 2002 whose renal failure was associated with diabetes has continuously increased each year over the preceding year. More than 53 million Europeans, 8.4% of adults, have diagnosed diabetes with a predicted increase to 9.8% of adults by 2025. Industrialized nations devote about 10% of their healthcare budgets to diabetes care, an estimate that must rise, due to continuing growth of diabetic persons, of about 7 million a year globally. Appreciating that reluctance to accept diabetic persons for ESRD treatment is fading, the financial impact imposed by treating the myriad comorbidities of diabetes must continuously expand. Developing nations, for the present, have avoided including diabetes in the roster of acceptable causes for treating