Nephrology Referral in Diabetes Practice

Abstract

Diabetic nephropathy, including diabetic kidney disease (DKD), is a major complication of diabetes. Appropriate management of DKD requires multispecialty intervention under the guidance of endocrinology and nephrology. However, delayed referral to specialized nephrology services usually occurs, and this leads to suboptimal outcomes. This multispecialty consensus suggests simple clinical and biochemical parameters that should prompt referral of DKD patients to nephrology. A checklist for physicians who manage DKD is also provided.

Keywords

chronic kidney disease - diabetic kidney disease - diabetic nephropathy - end-stage renal disease - type 1 diabetes - type 2 diabetes

• References

• 1 Saran R, Robinson B, Abbott KC. et al. US Renal Data System 2016 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 2017; 69 (03) (Suppl. 01) A7-A8
• 2 Thomas MC, Cooper ME, Zimmet P. Changing epidemiology of type 2 diabetes mellitus and associated chronic kidney disease. Nat Rev Nephrol 2016; 12 (02) 73-81
• 3 Tuttle KR, Bakris GL, Bilous RW. et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Am J Kidney Dis 2014; 64 (04) 510-533
• 4 Low S, Lim SC, Wang J. et al. Long term outcomes of patients with type 2 diabetes attending a multidisciplinary diabetes kidney disease clinic. J Diabetes 2017
• 5 American Diabetes Association. 10. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018; 41 (Suppl. 01) S105-S118
• 6 The Indian Council of Medical Research (ICMR). Guidelines for Management of Type 2 Diabetes. New Delhi, India: ICMR; 2018
• 7 Bajaj S. RSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2017. Int J Diabetes Dev Ctries 2018; 38 (01) (Suppl. 01) 1-115