Diabetic nephropathy

Diabetic nephropathy is a major cause of morbidity and mortality in both type 1 and type 2 diabetes. This is principally from coronary artery and other forms of cardiovascular disease, and particularly from heart failure, the incidence of which is about 15-fold greater in patients with diabetic kidney disease. Suboptimal glycaemic control and a higher blood pressure are particularly important risk factors for the development of diabetic nephropathy. The disease can be detected in most cases many years before the development of advanced renal failure through the detection of raised urinary albumin excretion – microalbuminuria. This allows time for the intensive treatment of glycaemic control, blood pressure and other cardiovascular risk factors, such as lipids, to reduce the morbidity and mortailty. Despite this, diabetes remains the single most common cause of end-stage renal failure.