Current management of diabetic patients with kidney disease: a renal‑cardio‑endocrine perspective

Area of Science:

• Nephrology
• Endocrinology
• Cardiology

Background:

• Diabetic kidney disease (DKD) is a major complication of type 2 diabetes, affecting one-third of patients.
• DKD significantly increases hospitalization and mortality rates, often due to cardiovascular issues.
• Managing DKD is complex, involving intricate interactions between kidney function, diabetes care, risk factors, and pharmacotherapy.

Purpose of the Study:

• To provide insights into current recommendations for evaluating and stratifying DKD.
• To elucidate how kidney disease influences the optimal management of diabetic patients.
• To adopt an integrated renal-cardio-endocrine perspective for comprehensive patient care.

Main Methods:

• This review synthesizes current literature and guidelines.
• It focuses on the interdisciplinary management of DKD.
• The approach integrates renal, cardiovascular, and endocrine considerations.

Main Results:

• DKD necessitates careful evaluation and risk stratification.
• Management strategies must account for the interplay of diabetes, kidney, and heart health.
• Pharmacological management requires attention to pharmacokinetics and side effects in renal impairment.

Conclusions:

• Integrated management is crucial for optimizing outcomes in diabetic patients with kidney disease.
• Early detection and stratification of DKD are essential.
• A multidisciplinary approach is vital to mitigate the high burden of DKD.