Peer Reviewed
Feature Article Endocrinology and metabolism
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The shifting paradigm of albuminuria in diabetic kidney disease

Anna K Watts, Karen M Dwyer, Elif I Ekinci, George Jerums, Richard J Macisaac

Diabetic kidney disease has been traditionally thought of as being a linear progression from microalbuminuria to macroalbuminuria to renal failure. New emerging concepts have proved this to be incorrect and are changing the way diabetic kidney disease is considered.

Key Points
  • Microalbuminuria may be transient and regress. This is more likely to occur if risk factors, such as blood glucose levels, blood pressure and lipid levels, are well controlled.
  • Normoalbuminuric (nonclassical) diabetic kidney disease accounts for at least 25% of patients with chronic kidney disease (CKD) and diabetes.
  • Although diabetic kidney disease is the most common cause of CKD in a patient with diabetes, other causes should be considered.
  • Care of patients with diabetes requires careful attention to modifiable factors such as dyslipidaemia and hypertension, as well as good glycaemic control.

    Picture credit: © Scott Bodell.

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