Diabetic Kidney Disease

Prim Care. 2020 Dec;47(4):645-659. doi: 10.1016/j.pop.2020.08.004. Epub 2020 Sep 23.

Abstract

Diabetic kidney disease (DKD) is the most common cause of chronic kidney disease in the United States. Approximately 30% to 40% of individuals with diabetes mellitus develop DKD, and the presence of DKD significantly elevates the risk for morbidity and mortality. Understanding of DKD has grown in recent years. This review describes the pathogenesis of DKD and expands on evidence-based strategies for DKD management, integrating traditional approaches for hyperglycemia, hypertension, and albuminuria management with emerging therapeutic options. Given the public health burden of DKD, it is essential to prioritize prevention, recognition, and management of DKD in the primary care setting.

Keywords: Albuminuria; Chronic kidney disease; Diabetic kidney disease; Diabetic nephropathy.

Publication types

  • Review

MeSH terms

  • Albuminuria
  • Blood Pressure
  • Comorbidity
  • Diabetic Nephropathies / diagnosis
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Nephropathies / therapy
  • Disease Progression
  • Glucagon-Like Peptide 1 / analogs & derivatives
  • Glycemic Control
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Primary Health Care
  • Referral and Consultation
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / physiology
  • Sodium-Glucose Transporter 2 Inhibitors

Substances

  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • Glucagon-Like Peptide 1