Clinical outcomes for patients with diabetic nephropathy

Diabetic nephropathy is the chief cause of morbidity and premature mortality in patients with diabetes with clinically significant renal disease being present in 30-50% of type 1 and 10% of type 2 diabetics after 10-20 years of the disease. End stage renal failure is commonly associated with other complications of diabetes, such as severe retinopathy and vasculopathy of the coronary, cerebral and peripheral arteries. Diabetic patients represent 35% in USA and about 20% in Europe of all new end stage renal disease patients. This paper reviews the current practices to prevent complications and discusses clinical issues and outcomes associated with the different renal replacement therapies.