Volume 2, Issue 2, March 2014, Page: 26-33
Preventing the Progression of Diabetic Kidney Disease
Sheikh Salahuddin Ahmed, Department of Internal medicine, Bangladesh Institute of Health Sciences (BIHS), Dhaka, Bangladesh
Received: Feb. 5, 2014;       Published: Mar. 20, 2014
DOI: 10.11648/j.ajim.20140202.14      View  3014      Downloads  238
Abstract
Diabetic kidney disease (DKD) is a progressive condition and is an important cause of end-stage renal disease (ESRD) causing increased morbidity and mortality. The objective of this review article is to discuss about recognition and treatment of early DKD to prevent its progression. Informations have been gathered from related clinical studies, research works, articles, abstracts, and guidelines of different organizations published in various journals. Microalbuminuria describes the urinary excretion of small amounts of albumin which identifies the early stage of DKD. In addition to an earliest marker of kidney damage, microalbuminuria is an established high risk factor for cardiovascular morbidity and mortality. Patients with microalbuminuria who progress to macroalbuminuria are likely to progress to ESRD. There is general agreement that people with diabetes should be screened regularly to detect early markers of kidney damage. Albumin creatinine ratio in a morning urine sample is the preferred method of detecting microalbuminuria in diabetes. There is strong evidence that a number of interventions if initiated at early stage of DKD reduces the risk and slows the progression of kidney damage. People with diabetes and microalbuminuria should be treated with a multifactorial intervention approach to retard the progression of DKD. Studies have clearly demonstrated that the use of angiotensin converting enzyme inhibitors or angiotensin 2 receptor blockers with improved glycemic control, blood pressure control, lipid lowering, aspirin, smoking cessation, exercise programs and dietary intervention reduced the development of overt nephropathy and ESRD.
Keywords
Diabetic Kidney Disease, Macroalbuminuria, Microalbuminuria
To cite this article
Sheikh Salahuddin Ahmed, Preventing the Progression of Diabetic Kidney Disease, American Journal of Internal Medicine. Vol. 2, No. 2, 2014, pp. 26-33. doi: 10.11648/j.ajim.20140202.14
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