Clinical assessment and treatment of diabetes in patients with chronic kidney disease

Rev Clin Esp (Barc). 2018 Aug-Sep;218(6):305-315. doi: 10.1016/j.rce.2018.03.016. Epub 2018 Apr 22.
[Article in English, Spanish]

Abstract

Diabetes mellitus type 2 is the main cause of chronic kidney disease. Patients with this disease have higher morbidity and mortality and risk of hypoglycaemia than those without this disease. In 2010, type 2 diabetes was the reason for starting renal replacement therapy in 24.7% of patients. The prevalence of microalbuminuria, proteinuria and a reduced glomerular filtration rate is 36%, 8% and 22%, respectively. The presence of albuminuria is a predictor of chronic kidney disease. Diabetic kidney disease, previously known as diabetic nephropathy, refers to kidney disease caused by diabetes. Renal hyperfiltration is a marker of intraglomerular hypertension and a risk factor for onset and progression. The new antidiabetic drugs, mainly dipeptidyl peptidase-4 inhibitors, sodium-glucose cotransporter inhibitors and glucagon-like peptide-1 agonists, have been shown to prevent or slow the progression of kidney disease.

Keywords: Chronic kidney disease; DPP4-i; Diabetes; Diabetic kidney disease; Diabetic nephropathy; Enfermedad renal crónica; Enfermedad renal del diabético; GLP-1RA; Nefropatía diabética; SGLT2-i; arGLP1; iDPP4; iSGLT2.