Diabetic Kidney Disease

  • Ting Cai
  • Junwei YangEmail author


Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) and is strongly associated with mortality in patients with diabetes. Persistent albuminuria is the hallmark of DKD, and some patients will finally develop ESRD with gradually decreased glomerular filtration rate (GFR) and increased serum creatinine concentration. Glomerular basement membrane thickening, mesangial expansion, mesangial matrix accumulation, Kimmelstiel–Wilson nodules, and tubulointerstitial fibrosis are typical pathological changes in DKD. Screening for DKD should begin at 5 years after the diagnosis of type 1 diabetes and at the diagnosis of type 2 diabetes, which should include measurement of urinary albumin-to-creatinine ratio and serum creatinine concentration, estimation of GFR, and ophthalmologic examination. The progression of DKD may be slowed by optimal therapeutic approaches, including lifestyle improvement, strict glycemic and blood pressure control, control of dyslipidemia, and renin–angiotensin–aldosterone system blockade. Patients who develop ESRD require renal replacement therapy.


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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Nanjing Medical UniversityNanjingChina
  2. 2.Centre for Kidney DiseaseSecond Affiliated Hospital, Nanjing Medical UniversityNanjingChina

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