Diabetic Nephropathy

Excerpt

Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD) in many developed countries, including the United States. As a microvascular complication, diabetic nephropathy affects individuals with both type 1 diabetes (T1D) and type 2 diabetes (T2D). The condition presents with persistent albuminuria and a progressive decline in the glomerular filtration rate (GFR). Substantial evidence indicates that early, aggressive treatment can delay or prevent the progression of the disorder. While diabetic nephropathy can develop in both T1D and T2D, the majority of diabetes cases (>90%) are T2D, which is primarily insulin-resistant. Please see StatPearls' companion resource, "Type 2 Diabetes," for more information.

Recent studies have led to updates in treatment guidelines, making it essential to review this extensive topic for providing optimal care to patients with diabetes and kidney disease. Recent guidelines from the Kidney Disease: Improving Global Outcomes (KDIGO) and several renal organizations recommend using the terms "diabetes and chronic kidney disease (CKD)" or "diabetic kidney disease (DKD)" instead of "diabetic nephropathy." However, all these terms are currently used in the literature. Additionally, the Kidney Disease Outcomes Quality Initiative (KDOQI) work group emphasizes the need for long-term multidisciplinary teams to address the widespread impact of diabetes and highlights the importance of holistic care and lifestyle modifications for effective management.