[Examination of the kidneys in a diabetic patient]

Diabetic nephropathy is the most frequent cause of terminal renal failure in the Czech Republic today. Diabetic patients should be screened for diabetic kidney disease on an annual basis, starting 5 years after diabetes was diagnosed in type 1 diabetes patients and immediately after diagnosis in type 2 diabetes patients. The screening includes determining the albumin/creatinine ratio from a urine sample, and of serum creatinine, and the calculation ofglomerular filtration rate. In patients in whom microalbuminuria and/or proteinuria were found, measures should be taken to reduce cardiovascular risk and to slow down the progression of renal disease. In diabetic patients with abnormal urine test results detailed nephrology examination is necessary to exclude other renal diseases than diabetic nephropathy, especially chronic glomerulonephritis and ischaemic nephropathy.