Glycemic Control in Diabetic CKD Patients

Where Do We Stand?

Csaba Kovesdy, Kumar Sharma, Kamyar Kalantar-Zadeh

Research output: Contribution to journalReview article

53 Citations (Scopus)

Abstract

Diabetes mellitus (DM) is a leading cause of chronic kidney disease (CKD) and a major source of morbidity and mortality in patients with established CKD. Loss of kidney function and dialytic therapies conspire to change glycemic regulation in ways that can both worsen and improve blood glucose control. Despite the unique nature of DM in patients with CKD, there currently are no specific guidelines to direct glycemic therapy in these patients. There is benefit of glycemic therapy in preventing such complications as diabetic kidney disease and mortality in patients with no kidney disease, but such benefits are largely unproven in patients with advanced CKD. By reviewing the relevant literature, we argue that glycemic control can still be beneficial in preventing complications, even in dialysis-dependent patients, but there is need for a much better understanding of the CKD-related characteristics of DM. More research is needed to determine whether uremia-related improvement in glycemic control can have a beneficial impact. Finally, we are at an important crossroads in the development of several novel therapeutic agents against diabetic kidney disease. We provide an overview of such agents and their stage of development.

Original languageEnglish (US)
Pages (from-to)766-777
Number of pages12
JournalAmerican Journal of Kidney Diseases
Volume52
Issue number4
DOIs
StatePublished - Oct 1 2008

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Diabetic Nephropathies
Chronic Renal Insufficiency
Diabetes Mellitus
Mortality
Uremia
Kidney Diseases
Therapeutics
Blood Glucose
Dialysis
Guidelines
Morbidity
Kidney
Research

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Glycemic Control in Diabetic CKD Patients : Where Do We Stand? / Kovesdy, Csaba; Sharma, Kumar; Kalantar-Zadeh, Kamyar.

In: American Journal of Kidney Diseases, Vol. 52, No. 4, 01.10.2008, p. 766-777.

Research output: Contribution to journalReview article

Kovesdy, Csaba ; Sharma, Kumar ; Kalantar-Zadeh, Kamyar. / Glycemic Control in Diabetic CKD Patients : Where Do We Stand?. In: American Journal of Kidney Diseases. 2008 ; Vol. 52, No. 4. pp. 766-777.
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