Diabetic nephropathy is characterized by gradually increasing urinary albumin excretion and blood pressure as the glomerular filtration rate falls insidiously towards end-stage renal disease.

Onset usually >10years after diabetes diagnosis

Diabetic nephropathy is the most common cause of glomerular pathology and chronic kidney disease in the UK.

• commonest cause of end-stage renal disease (ESRD) in the western world
• 33% of patients with type 1 diabetes mellitus have diabetic nephropathy by the age of 40 years
• approximately 5-10% of patients with type 1 diabetes mellitus develop (ESRD)
• It is the leading cause of premature death in young people with diabetes

Risk factors

Modifiable

• Hypertension
• Hyperlipidaemia
• Smoking
• Poor glycaemic control
• Raised dietary protein

Non-modifiable

• Male sex
• Duration of diabetes
• Genetic predisposition (e.g. ACE gene polymorphisms)