Diabetic nephropathy consists of renal damage attributable to diabetes and is one of the causes of chronic kidney disease (CKD). It is characterised by the findings of proteinuria and a fall in glomerular filtration rate (GFR) – alongside retinopathy and neuropathy, CKD represents a microvascular complication of diabetes.
Diabetic nephropathy is the most common cause of end-stage renal failure (ESRF) both in the UK and worldwide.1 It also carries significant adverse cardiovascular implications.2 Importantly, early recognition provides the opportunity to halt progression of diabetic nephropathy and reduce the risk of complications.
The scale of the problem
People with both Type 1 and Type 2 diabetes are at risk of nephropathy and the prevalence is rising rapidly in line with the dramatic increase in Type 2 diabetes globally.
It has been estimated that CKD will develop in up to 40% of people with diabetes.3 Of these, a significant proportion will progress to ESRF requiring dialysis and/or renal transplantation with accompanying profound personal and social consequences.
In poorer countries these treatment modalities may simply be unavailable, and in some countries the economic consequences are substantial.4
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