Recommendations: Nephropathy

General recommendations for the care of patients with diabetes and nephropathy1 are summarized on this slide To reduce the risk or slow the progression of nephropathy, optimize glucose control (A) To reduce the risk or slow the progression of nephropathy, optimize blood pressure control (A) Diabetic nephropathy occurs in 20-40% of patients with diabetes and is the single leading cause of end-stage renal disease (ESRD) Persistent albuminuria in the range of 30-299 mg/24 h (historically called microalbuminuria) has been shown to be the earliest stage of diabetic nephropathy in type 1 diabetes and a marker for development of nephropathy in type 2 diabetes Microalbuminuria is also a well-established marker of increased CVD risk2,387References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S34-S35. Garg JP, Bakris GL. Microalbuminuria: marker of vascular dysfunction, risk factor for cardiovascular disease. Vasc Med 2002;7:35-43. Klausen K, Borch-Johnsen K, Feldt-Rasmussen B, et al. Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes. Circulation 2004;110:32-35.