A Brief Note On Diabetic Kidney Disease ( Dkd )

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Diabetic Kidney Disease Diabetic kidney disease (DKD) is defined kidney disease attributed to diabetes (versus chronic kidney disease, which may be due to numerous etiologies including diabetes). ADA recommends screening for nephropathy 5 years after diagnosis for type 1 diabetes and at diagnosis for type 2 diabetes. Screening includes urine albumin excretion (albumin/gr creatinine). ADA no longer uses the terms “micro (< 30 ug/mg Cr) and macroalbuminuria (> ug/mg Cr)”, but defines albuminuria as a continuum. The term “microalbuminuria” implies less serious disease, which is not true. Glomerular filtration rate (GFR) is used to assess kidney function. Since it is difficult to measure GFR directly, the secretion of an endogenous filtration marker (e.g. serum creatinine) is used to estimated GFR (eGFR). eGFR depends on age, gender, weight and ethnicity. Younger people have higher eGFR due to more muscle mass and average creatinine generation rate (ref NKF FAQ GFR). Since nephropathy is linked with hypertension, providers should closely monitor blood pressure (ref). Diabetic kidney disease may be preventable, so it is important for pediatric health care professionals to understand screening, risk factors, prevention, and treatment options. Overt diabetic kidney disease remains uncommon in youth. Although one retrospective study in type 1 diabetes subjects found that end-stage renal disease occurred in 2.9% of its population, with a significant association

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