SECTION 2:

The importance of early recognition of diabetic kidney disease

Reductions in renal function have been linked to cardiovascular risk, offering an early warning system. People with microalbuminuria have a 50% increased risk of coronary heart disease.1 This underlines the importance of regular renal assessment, especially for those with conditions which are known to have an increased risk of kidney involvement or cardiovascular disease such as type 2 diabetes.2,3

If recognised early, diabetic kidney disease can be effectively treated.4 Tight control of blood glucose levels and blood pressure significantly reduces the incidence and progression of DKD.4 In people with type 2 diabetes, inhibition of the renin-angiotensin system, through treatment with an angiotensin-converting-enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) reduces progression from microalbuminuria to macroalbuminuria, and slows the development of end stage renal disease (ESRD).4 Treatment of DKD reduces cardiovascular complications as well as kidney failure.5

Job code: UK/DIA-19020d DOP: June 2020

References

  1. Perkovic V, Verdon C, Ninomiya T, et al. The relationship between proteinuria and coronary risk: a systematic review and meta-analysis. PLoS Med. 2008;5(10):e207
  2. Herzog CA, Asinger RW, Berger AK, Charytan DM, Díez J, et al. Cardiovascular disease in chronic kidney disease. A clinical update from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2011; https://doi.org/10.1038/ki.2011.223 [Accessed June 2020]
  3. Plantinga LC, Crews DC, Coresh J, Miller ER, Saran R, et al. Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clin J Am Soc Nephrol. 2010; https://doi.org/10.2215/CJN.07891109 [Accessed June 2020]
  4. Couser WG, Remuzzi G, Mendis S, et al. The contribution of chronic kidney disease to the global burden of major non-communicable diseases. Kidney Int 2011;80(12):1258-70
  5. Diabetes UK. Preventing kidney failure in people with diabetes: Position statement; August 2016. https://www.diabetes.org.uk/professionals/position-statements-reports/specialist-care-for-children-and-adults-and-complications/preventing-kidney-failure-in-people-with-diabetes [Accessed June 2020]