Diabetic Kidney Disease

Review
In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
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Excerpt

Diabetes is the most common cause of end-stage kidney disease (ESKD) in the US and other developed countries. Diabetic nephropathy is a chronic condition characterized by a gradual increase in urinary albumin excretion, blood pressure levels and cardiovascular risk, and declining glomerular filtration rate (GFR), which can progress to ESKD. Chronic kidney disease (CKD) is common among patients with diabetes, and it develops in approximately 50% of the patients with type 1 diabetes (T1D) and 30% of those with type 2 diabetes (T2D). Patients with diabetes should be screened for CKD annually. Screening should include both albuminuria measurements and estimates of GFR. The kidney structural changes of diabetic nephropathy are unique to this disease, and closely correlate with kidney function. Multiple factors are associated with CKD in diabetes, and patients with diabetes often require multiple therapies aimed at prevention of progressive CKD and its associated co-morbidities and mortality. Management of cardiorenal risk factors, including lifestyle modifications (diet, exercise, and stop smoking), glucose, blood pressure and lipid control, use of agents blocking the renin angiotensin aldosterone system and use of SGLT2 inhibitors in patients with T2D and other agents with proven renal or cardiovascular benefit are the cornerstones of therapy. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, WWW.ENDOTEXT.ORG.

Publication types

  • Review