This second article on diabetic kidney disease looks at management of the condition (to read part one, click here). The key aims in managing DKD are to reduce the risk of cardiovascular (CV) events and slow the progression of renal disease1 and there are now several medications that offer both of these possibilities (see table 1).
Bearing in mind the increased risk of cardiovascular disease (CVD) in DKD the healthy diet advised for people with diabetes is of great importance. Where appropriate, weight reduction, regular exercise and smoking cessation should be encouraged.1,2 Limiting salt intake is helpful in managing hypertension. In advanced DKD restriction of potassium and phosphate may be necessary, although by this stage the individual may well be under specialist care and have access to a renal dietician.