Screening tests for renal impairment in patients with type 2 diabetes: the what, when, and how

The global course of obesity and diabetes presents an alarming forecast for the near future. As the prevalence rates continue to increase and the afflicted population grows younger in age, the associated complications of diabetes will come to pose a greater strain on patients, society, and national health care systems. In recent years, a number of studies have demonstrated the clinical benefits of strict diabetes control in the prevention of debilitating complications, including retinal, renal, and cardiovascular disease. These data highlight the need to maximize our efforts in diabetes prevention and early disease management. Renal dysfunction is a surrogate marker of diabetic microvascular disease, and thus early recognition of renal impairment in patients with diabetes provides an opportunity to modify treatment strategy and improve long-term disease outcomes. This review will summarize methods of assessing renal function and the most recent guidelines for the early screening and diagnosis of diabetic kidney disease.