Diabetic nephropathy is the most common cause of glomerular pathology and chronic kidney disease in the UK. The chronic high level of glucose passing through the glomerulus causes scarring. This is called glomerulosclerosis.
Proteinuria is a key feature of diabetic nephropathy. This is due to damage to the glomerulus allowing protein to be filtered from blood to urine.
Patients with diabetes should have regular screening for diabetic nephropathy by testing the albumin:creatinine ratio and U&Es.
Management
Treatment is by optimising blood sugar levels and blood pressure.
ACE inhibitors are the treatment of choice in diabetics for blood pressure control. They should be started in patients with diabetic nephropathy even if they have a normal blood pressure.
Last updated April 2019