Glomerular Diseases in Diabetic Patients: Implications for Diagnosis and Management

• Published in: Journal of clinical medicine Vol. 10; no. 9; p. 1855
• Main Authors: Oliva-Damaso, Nestor, Mora-Gutiérrez, José María, Bomback, Andrew S
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.04.2021; MDPI
• Subjects: Biopsy; Blood pressure; Clinical medicine; Diabetes; Diabetic nephropathy; Glucagon; Health risk assessment; Hypertension; Kidney diseases; Obesity; Peptides; Review; IgA nephropathy; nondiabetic renal disease; nondiabetic kidney disease; diabetes mellitus; focal segmental glomerulosclerosis; glomerulonephritis; obesity-related glomerulopathy
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10091855

The prevalence of diabetes continues to rise worldwide. In addition to rising rates of diabetic kidney disease, we are also seeing a parallel rise in nondiabetic kidney disease among patients with diabetes. These nondiabetic lesions include focal segmental glomerulosclerosis, IgA nephropathy, membranous nephropathy, and other glomerular diseases. The management of diabetic kidney disease is rapidly evolving to include, beyond glycemic control and renin angiotensin inhibition, the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors and mineralocorticoid receptor antagonists. These and other new treatment strategies should be applicable to managing glomerular disease in diabetic patients to reduce toxicities associated with immunosuppression and, in particular, corticosteroids. The prevalence of glomerular disease in diabetic patients is underappreciated. Diagnosis and appropriately treating these diseases remain an important avenue to modify kidney outcomes in diabetic patients.