Which patients are at high risk for end-stage renal disease (ESRD) from diabetic nephropathy?

Updated: Oct 09, 2019
  • Author: Vecihi Batuman, MD, FASN; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

A study by Zhang et al suggested that the presence of diabetic retinopathy is an independent risk factor for the advancement of diabetic nephropathy to ESRD in patients with type 2 DM. [16]

A study by Jiang et al indicated that a higher number of comorbidities in patients with type 2 DM increases the likelihood that diabetic nephropathy will progress. Dividing the study’s patients into four groups—low comorbidity/low treatment, low comorbidity/high treatment, moderate comorbidity/high insulin use, and high comorbidity/moderate treatment—the investigators found the subjects’ 5-year diabetic nephropathy progression rates to be 11.8%, 18%, 16.5%, and 27.7%, respectively. [17]

A study by Rosolowsky et al reported that despite renoprotective treatment, including transplantation and dialysis, patients with type 1 diabetes and macroalbuminuria remain at high risk for ESRD. [18]


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