The Heart and Diabetic Nephropathy

BACKGROUND

Diabetic nephropathy represents the most common etiology for stage 5 chronic kidney disease in the United States, resulting in the need for dialysis and transplantation. It is estimated that about one-third of U.S. patients who need renal replacement therapy are diabetics.

Chronic kidney disease (CKD) of any etiology is associated with cardiovascular disease and is more predictable in patients with diabetic nephropathy.¹ Such individuals have an increased incidence of coronary artery disease and hypertension but also can have diabetic cardiomyopathy due to microvascular complications of diabetes.² Optimal blood pressure, blood sugar, and blood lipid control as well as cessation of smoking are of utmost importance in preventing progression of cardiovascular, renal, and end-organ damage. Similarly, early recognition and treatment of microalbuminuria (a manifestation of systemic endothelial dysfunction) is extremely important in improving cardiovascular and renal outcomes.³