Diagnosis and Management of Type 2 Diabetic Kidney Disease

Abstract

Type 2 diabetic kidney disease (DKD) is the most common cause of CKD and ESRD worldwide, and carries with it enormous human and societal costs. The goal of this review is to provide an update on the diagnosis and management of DKD based on a comprehensive review of the medical literature. Topics addressed include the evolving presentation of DKD, clinical differentiation of DKD from non-DKD, a state-of-the-art evaluation of current treatment strategies, and promising emerging treatments. It is expected that the review will help clinicians to diagnose and manage patients with DKD.

Keywords: Chronic; Costs and Cost Analysis; Diabetic Nephropathies; Disease Management Disease Management; Goals; Humans; Kidney Failure; Publications; Renal Insufficiency.

Figure 1.

Empagliflozin was associated with improved renal outcomes compared to placebo. (A) Estimates of the probability of the first occurrence of the prespecified composite renal outcomes defined as incident or worsening nephropathy. (B) Estimates of the probability of the post hoc renal composite outcomes defined as doubling of serum creatinine level, death from renal disease, or requirement of RRT. Hazard ratios shown are from Cox regression analysis (35). 95% CI, 95% confidence interval.