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Review
. 2020 Jul;24(7):573-581.
doi: 10.1007/s10157-020-01881-0. Epub 2020 Mar 31.

Nonproteinuric diabetic kidney disease

Masayuki Yamanouchi  1   2   3   4 , Kengo Furuichi  5 , Junichi Hoshino  6   7 , Yoshifumi Ubara  6   7 , Takashi Wada  8
Affiliations
Review

Nonproteinuric diabetic kidney disease

Masayuki Yamanouchi et al. Clin Exp Nephrol. 2020 Jul.

Abstract

Proteinuria has been considered to be the hallmark of diabetic kidney disease and to precede renal function loss. However, it has become clear that a substantial proportion of patients either with type 1 diabetes or type 2 diabetes have renal function loss without proteinuria, known as nonproteinuric diabetic kidney disease. Despite increasing recognition of the prevalence of nonproteinuric diabetic kidney disease, data on this phenotype of diabetic kidney disease is sparse. This review describes ever known clinical and pathological manifestations, renal prognosis, and mortality in patient with nonproteinuric diabetic kidney disease.

Keywords: Diabetic kidney disease; Diabetic nephropathy; End-stage kidney disease; Nonproteinuric diabetic kidney disease; Proteinuria.

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Figures

Fig. 1
Fig. 1
General concept of natural history of proteinuric diabetic kidney disease. Proteinuric diabetic kidney disease develops proteinuria prior to renal function loss. eGFR estimated glomerular filtration rate, UACR urine albumin to creatinine ratio
Fig. 2
Fig. 2
General concept of natural history of nonproteinuric diabetic kidney disease. Nonproteinuric diabetic kidney disease does not always develop proteinuria prior to renal function loss. In addition, it remains unclear whether nonproteinuric patients finally develop proteinuria and progress to ESKD. eGFR estimated glomerular filtration rate, UACR urine albumin to creatinine ratio
Fig. 3
Fig. 3
Pathology of nonproteinuric diabetic kidney disease. Majority of patients with nonproteinuric diabetic kidney disease have minor changes in glomerular histology
See this image and copyright information in PMC

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