Vascular complications in diabetic kidney disease patients

Patients with diabetic kidney disease develop various vascular complications involving various systems of the body. The pathophysiology involved is the endothelial dysfunction associated with hypertension, dyslipidemia and diabetes, activation of inflammatory pathways, and rennin-angiotensin system resulting in accelerated atherosclerosis due to increased production of reactive oxygen species and increased calcification. These patients have increased cardiovascular morbidity and mortality. In addition, these patients develop more complications related to vascular access needed for dialysis when they develop end-stage renal disease. An understanding of these complications and their pathophysiology will help in the prevention and early management of these complications resulting in better outcome of these patients.