FEATURES OF CHRONIC KIDNEY DISEASE IN TYPE 2 DIABETES MELLITUS, GOALS OF SCREENING, DIAGNOSIS AND TREATMENT, RECOMMENDATIONS
Keywords:
Diabetic kidney disease; type 2 diabetes; chronic kidney disease; ratio of albumin and creatinine in urine.Abstract
Patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are
at increased risk of progression of CKD and cardiovascular disease (CVD). The prevalence of CKD in
patients with T2DM is currently about 40% and is constantly increasing. Treatment of CKD in For
patients with T2DM, the goal is to maintain kidney function to reduce the risk of end-stage renal
disease, cardiovascular events, and death. Evidence-based guidelines for the management of patients
with CKD and T2DM are provided by several international and national organizations, which
recommend several lifestyle and pharmacological approaches to prevent or slow the progression of
CKD in patients with T2DM. Recommendations include regular screening for CKD and assessment of
glomerular filtration rate (at least once a year and at least twice a year if UACR 300 mgg) in patients
with T2DM using the urine albumin-to-creatinine ratio (UACR). In addition, vascular complications
should be assessed alongside interventions to improve glycemic control and lipid levels, maintain
healthy weight, and optimize blood pressure; drugs that slow the progression of coronary artery
disease include renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, and
glucagon-like peptide-1 receptor agonists. glucagon-like peptide-1 receptor agonists and, more
recently, selective nonsteroidal mineralocorticoid receptor antagonists. This review addresses the
current challenges faced by primary care physicians in managing CKD in patients with T2DM,
including managing comorbidities, implementing new treatments, and implementing personalized
care. Achieving consensus on optimal management of this disease is critical to ensuring consistent and
appropriate care for all patients. Strategies to improve outcomes should also include using clear
referral criteria, multidisciplinary approaches and patient education.
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