Review article
DIABETIC NEPHROPATHY AS A CAUSE OF CHRONIC KIDNEY DISEASE
IVAN KOS
orcid.org/0000-0002-5366-4092
; Merkur University Hospital, Clinical Department of Internal Medicine, Zagreb, Croatia
INGRID PRKAČIN
orcid.org/0000-0002-5830-7131
; Merkur University Hospital, Clinical Department of Internal Medicine;Zagreb University School of Medicine, Zagreb, Croatia
Abstract
Diabetic nephropathy is the leading cause of end-stage chronic kidney disease in most developed countries. Hyperglycemia, hypertension and genetic predisposition are the main risk factors for the development of diabetic nephropathy. Elevated serum lipids, smoking habits, and the amount and origin of dietary protein also seem to play a role as risk factors. Clinical picture includes a progressive increase in albuminuria, decline in glomerular fi ltration, hypertension, and a high risk of cardiovascular morbidity and mortality. Screening for albuminuria should be performed yearly, starting 5 years after diagnosis in type 1 diabetes or earlier in the presence of adolescence or poor metabolic control. In patients with type 2 diabetes, screening should be performed at diagnosis and yearly thereafter. Patients with albuminuria should undergo evaluation regarding the presence of associated comorbidities, especially retinopathy and macrovascular disease. Achieving the best metabolic control (HbA1c <7%), treating hypertension (target blood pressure <140/85 mm Hg), using drugs with blockade effect on the renin-angiotensin-aldosterone system,
treating dyslipidemia and anemia are effective strategies for preventing the development of albuminuria, delaying the progression to more advanced stages of nephropathy and reducing cardiovascular mortality in patients with type 1 and type 2 diabetes.
Keywords
diabetic nephropathy; chronic kidney disease
Hrčak ID:
142199
URI
Publication date:
22.7.2015.
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