The Main Approaches in the Treatment of Chronic Kidney Disease Based on International Recommendations

Diabetic nephropathy (DN) is a serious health problem. It occurs in 50% of people living with diabetes, is the main cause of terminal stage kidney disease (TSKD) requiring treatment with dialysis or kidney transplantation, and is associated with a significant increase in cardiovascular morbidity and mortality. DN is a clinical syndrome characterized by persistent albuminuria and progressive decrease in kidney function, but it is increasingly recognized that the manifestations and clinical course of kidney disease in diabetes are heterogeneous. The term "diabetic kidney disease" (DBP) is currently widely used to refer to people with diabetes who have either albuminuria or decreased kidney function. This article will discuss the clinical picture and approach to the diagnosis of DBP, as well as its prognosis. The general principles of DKD management will also be reviewed with reference to the current international recommendations.