Diabetic Kidney Disease: Its Pathogenesis and Management

Main Article Content

Mandip Singh Bhatia
Ritu Attri
Ishwardip Singh Kwatra
Rajni Kant Kumar


As the prevalence of diabetes is increasing in India, there is equal rise in the number of the patients with micro and macro vascular complications related to diabetes. The prevalence of diabetic kidney disease is increasing in Indian population because of genetic and non-genetic reasons. Because of paucity of data we don’t have exact numbers but it is the leading cause of end stage kidney disease in Indian population. Early screening for kidney disease and aggressive control of blood pressure and glycemic control can slow down and even prevent the progression of diabetic kidney disease.

Diabetic kidney disease, renal disease, diabetes, diabetic nephropathy.

Article Details

How to Cite
Bhatia, M. S., Attri, R., Kwatra, I. S., & Kumar, R. K. (2019). Diabetic Kidney Disease: Its Pathogenesis and Management. International Journal of Advances in Nephrology Research, 2(1), 1-10. Retrieved from http://journalijanr.com/index.php/IJANR/article/view/30093
Review Article


Tang SC, Chan GC, Lai KN. Recent advances in managing and understanding diabetic nephropathy.F1000 Res; 2016.

Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Lancet diabetes Endocrinol. 2017;5(8):585-596.

USRDS: United States Renal Data System Annual Data Report: Epidemiology of Kidney Disease in the United States, Bethesda, MD, National Institute of Diabetes and Digestive and Kidney Diseases; 2015.

Reutens AT: Epidemiology of diabetic kidney disease. Med Clin North Am. 2013;97:1–18.

Bilous R. Microvascular disease: What does the UKPDS tell us about diabetic nephropathy? Diabet Med. 2008;25(Suppl 2):25–29.

The United Kingdom Prospective Diabetes Study. Adler et al for the UKPDS Group. Kidney Int. 2003;63:225-232.

Tikellis C, Bernardi S, Burns WC. Angiotensin‐converting enzyme 2 is a key modulator of the renin‐angiotensin system in cardiovascular and renal disease. Curr Opin Nephrol Hypertens 2010;20:62–68.

Bonnet F, Cooper ME, Kawachi H, et al. Irbesartan normalises the deficiency in glomerular nephrin expression in a model of diabetes and hypertension. Diabetologia. 2001;44:874–877.

Lewis EJ, Hunsicker LG, Bain RP. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group [published erratum appears in N Engl J Med N Engl J Med. 1993;329(20):1456-62. [Medline]

Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019;380:2295.

Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and progression of kidney disease in type 2 diabetes. N Engl J Med 2016;375:323.

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial Heerspink HJL, Parving HH, Andress DL, Bakris G, Correa-Rotter R, Hou FF, et al. SONAR Committees and Investigator Lancet. 2019;393(10184):1937.

Imam TH. Changes in metformin use in chronic kidney disease. Clin. Kidney J. 2017;10:301–304.
DOI: 10.1093/ckj/sfx017

Foundation NK. KDOQI clinical practice guideline for diabetes and CKD: 2012 Update. Am J Kidney Dis. Elsevier Inc. 2012;60(5):850–86.

Hasslacher C. Safety and efficacy of repaglinide in type 2 diabetic patients with and without impaired renal function. Diabetes Care. 2003;26(3):886–91.

Williams ME, Garg R. Glycemic management in ESRD and earlier stages of CKD. Am J Kidney Dis. 2014;63(2 Suppl 2):S22–38.

Eligar VS, Bain SC. A review of sitagliptin with special emphasis on its use in moderate to severe renal impairment. Drug Des Devel Ther. 2013;7:893–903.

Russo E, Penno G, Del Prato S. Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: Focus on vildagliptin. Diabetes Metab Syndr Obes. 2013;6:161–70.

Nowicki M1, Rychlik I, Haller H, Warren ML, Suchower LGNI. Saxagliptin improves glycaemic control and is well tolerated in patients with type 2 diabetes mellitus and renal impairment. Diabetes Obes Metab. 2011;13(6):523–32.
DOI: 10.1111/j.1463-1326.2011.01382

von Eynatten M, Gong Y, Emser A, Woerle HJ. Cardiovasc Diabetol. Efficacy and safety of linagliptin in type 2 diabetes subjects at high risk for renal and cardiovascular disease?: A Pooled Analysis of Six Phase III Clinical Trials. 2013;1–9.
DOI: 10.1186/1475-2840-12-60.

Giorda CB, Nada E, Tartaglino B. Pharmacokinetics, safety, and efficacy of DPP-4 inhibitors and GLP-1 receptor agonists in patients with type 2 diabetes mellitus and renal or hepatic impairment. A systematic review of the literature. Endocrine. 2014;46(3):406–19.
DOI: 10.1007/s12020-014-0179-0.

Ruggenenti P, Flores C, Aros C, Ene-Iordache B, Trevisan R, Ottomano C, et al. Renal and metabolic effects of insulin lispro in type 2 diabetic subjects with overt nephropathy. Diabetes Care.