Glycemic variability may be a factor in the development of DKD, but definitive evidence is lacking. Currently, all available glycemic biomarkers, including A1C, have limitations and in the setting of DKD and should be used cautiously. Emerging data suggest that personal and professional CGM will play an important role in managing diabetes in patients with DKD, where risk of hypoglycemia is high (Current Diabetes Reports)
Diabetes News
Category: Nephropathy
Nerve function varies with hemoglobin A1c in controls and type 2 diabetes
These findings underscore the importance of early treatment at the prediabetes and early diabetes stages to prevent nerve fiber decline that is likely irreversible (Diabetes and Its Complications)
Glucose targets for preventing diabetic kidney disease and its progression
Overall, this evidence summary does not support the use of tighter glucose control to offer people with diabetes a lower risk of premature mortality or protection against kidney failure (Cochrane)
ACE Inhibitors and Statins in Adolescents with Type 1 Diabetes
The use of an ACE inhibitor and a statin did not change the albumin-to-creatinine ratio over time (NEJM)
Alprostadil protects type 2 diabetes mellitus patients treated with metformin from contrast-induced nephropathy
Alprostadil hydration was superior to drinking water monohydration regarding preventing CIN in T2DM patients treated with metformin after contrast-enhanced CT (International Urology and Nephrology)
Acute Kidney Injury in Patients on SGLT2 Inhibitors: A Propensity-Matched Analysis
Our findings do not suggest an increased risk of AKI associated with SGLT2 inhibitor use in patients with T2D in two large health systems (Diabetes Care)
Association of angiotensin-II levels with albuminuria in subjects with normal glucose metabolism, prediabetes, and type 2 diabetes mellitus
Angiotensin-II may play an important role in the development of albuminuria, particularly in subjects with impaired glucose metabolism (Journal of Diabetes and Its Complications)
Classification and Differential Diagnosis of Diabetic Nephropathy
Regardless of its limitations, the Tervaert classification represents a very meaningful step towards the establishment of a DN classification scheme with clinical utility. When the pathologist observes the pathological changes of DN, they still need to make a differential diagnosis with another nodular glomerulopathy and clarify whether it is a typical DN complicated with NDRD or not (Journal of Diabetes Research)
HbA1c variability in type 2 diabetes is associated with the occurrence of new-onset albuminuria within three years
HbA1c-CV improves 3-year prognostication of new-onset albuminuria. Together with mean HbA1c, baseline urine albumin and presence of hypertension, accurate 3-year new-onset albuminuria prognostication may be possible (Diabetes Research and Clinical Practice)
Assessment of urinary microparticles in normotensive patients with type 1 diabetes
Taken together, our data show that urinary podocyte MP levels are higher in patients with type 1 diabetes in advance of changes in other biomarkers (albuminuria, nephrin). Examination of podocyte MPs may serve as an early biomarker of glomerular injury in uncomplicated type 1 diabetes (Diabetologia)
National Chronic Kidney Disease Audit
Chronic Kidney Disease (CKD) is a long-term irreversible deterioration in the function of the kidneys often found in patients who also have diabetes and high blood pressure (HQIP)
Renal Protective Effect of DPP-4 Inhibitors in Type 2 Diabetes Mellitus Patients: A Cohort Study
Administration of DPP-4i reduces urine albumin excretion and mitigates reduction of eGFR in T2DM patients (Journal of Diabetes Research)
Combined Diabetes-Renal Multifactorial Intervention in Patients with Advanced Diabetic Nephropathy: Proof-of-Concept
The intervention delayed ESRD. Improved A1C and ACR plus not-yet-identified variables may have influenced better outcomes. Multifactorial-multidisciplinary care may serve as a CKD 3–4 treatment paradigm (Journal of Diabetes and Its Complications)
Urine Proteome Specific for Eye Damage Can Predict Kidney Damage in Patients With Type 2 Diabetes: A Case-Control and a 5.3-Year Prospective Cohort Study
Urine haptoglobin, which is specific for PDR, is a novel biomarker and complement to urine albumin for predicting kidney damage in patients with T2D (Diabetes Care)
Plasma Triglycerides and HDL-C Levels Predict the Development of Diabetic Kidney Disease in Subjects With Type 2 Diabetes: The AMD Annals Initiative
In a large population of outpatients with diabetes, low HDL-C and high TG levels were independent risk factors for the development of DKD over 4 years (Diabetes Care)
Clinical predictors differentiating non-diabetic renal diseases from diabetic nephropathy in a large population of type 2 diabetes patients
Shorter duration of diabetes (⩽5 years), absence of retinopathy, and presence of glomerular hematuria were independent indicators associated with NDRDs, indicating the need for renal biopsy (Diabetes Research and Clinical Practice)
Dipeptidyl peptidase −4 activity is associated with urine albumin excretion in type 1 diabetes
Our results indicate that serum DPP-4 activity is associated with albuminuria in type 1 diabetes. This arises the question whether the use of DPP-4 inhibitors might serve as an additional therapeutic strategy to prevent proteinuria in patients with DKD (Journal of Diabetes and Its Complications)
Clinical Manifestations of Kidney Disease Among US Adults With Diabetes, 1988-2014
Among US adults with diabetes from 1988 to 2014, the overall prevalence of diabetic kidney disease did not change significantly, whereas the prevalence of albuminuria declined and the prevalence of reduced eGFR increased (JAMA)
Interactions between kidney disease and diabetes: dangerous liaisons
Understanding the renal physiology and pathophysiology of DKD has become essential to all specialties treating diabetic patients (Diabetology & Metabolic Syndrome)
Individualized prediction of the effect of angiotensin receptor inhibition on renal and cardiovascular outcomes in patients with diabetic nephropathy
The combined effects of ARBs on ESRD and CVD and mortality in patients with diabetic nephropathy varies considerably between patients. A substantial proportion of patients remain at high risk for both outcomes despite ARB treatment (Diabetes, Obesity and Metabolism)
Glycosmedia is also available as an App: