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Update on Diabetic Nephropathy: Core Curriculum 2018.
Kausik Umanath1, Julia B Lewis2
1Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI.
Summary
Diabetic kidney disease is a major cause of end-stage kidney disease. Renin-angiotensin system blockers are the best evidence-based therapy for diabetic nephropathy management.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- Diabetic kidney disease (DKD) and diabetic nephropathy are leading causes of end-stage kidney disease (ESKD).
- Diabetes contributes to 30-50% of new ESKD cases in the US.
- Only 30-40% of diabetic patients develop nephropathy, highlighting the need for targeted management.
Observation:
- Treatment strategies for diabetic nephropathy encompass cardiovascular risk reduction, glycemic control, blood pressure management, and renin-angiotensin system (RAS) inhibition.
- Therapeutic goals include hemoglobin A1c < 7% and blood pressure < 140/90 mmHg.
- RAS-blocking agents are central to managing diabetic nephropathy.
Findings:
- Renin-angiotensin system (RAS) blockade represents the most effective evidence-based therapy for diabetic nephropathy.
- This Core Curriculum details the epidemiology, pathophysiology, diagnosis, and management of diabetic nephropathy.
Implications:
- Effective management of diabetic nephropathy is crucial for reducing the burden of ESKD.
- Targeted therapies, particularly RAS inhibition, can significantly impact patient outcomes.
- Understanding the multifaceted approach to diabetic nephropathy management is vital for healthcare professionals.
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