Diabetic nephropathy

Abstract

Diabetes mellitus (DM) is the most frequent cause of severe chronic kidney disease (CKD) and is the leading cause of end-stage renal disease (ESRD) in Western countries. It occurs in 20-40% of patients with diabetes and is associated with great morbidity and mortality. Even in developed countries, fewer than 1 in 20 patients with DM and CKD survive to ESRD, succumbing due to cardiovascular disease (CVD), heart failure or infection, and the severity of diabetic renal disease significantly contributes to this outcome. Diabetic nephropathy is a specific renal condition characterized by hyperfiltration, persistent albuminuria of >300 mg/day, continuous decline in the glomerular filtration rate (GFR), raised arterial blood pressure (BP), and enhanced cardiovascular morbidity and mortality. Early diagnosis and appropriate management, especially when associated with control of glycemia, blood pressure and other comorbidities, may be related to better outcomes.