Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min)

Abstract

Diabetes mellitus is becoming increasingly prevalent and is considered a rapidly growing concern for healthcare systems. Besides the cardiovascular complications, diabetes mellitus is associated with chronic kidney disease (CKD). CKD in patients with diabetes can be caused by true diabetic nephropathy, but can also be caused indirectly by diabetes, e.g. due to polyneuropathic bladder dysfunction, increased incidence of relapsing urinary tract infections or macrovascular angiopathy. However, many patients who develop CKD due to a cause other than diabetes will develop or may already have diabetes mellitus. Finally, many drugs that are used for management of CKDs, e.g. corticosteroids or calcineurin inhibitors, can cause diabetes.