What are renal complications of diabetic nephropathy?

Updated: Oct 09, 2019
  • Author: Vecihi Batuman, MD, FASN; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Renal complications of diabetic nephropathy include increased risk of urinary tract infections, which may be further increased with the use of SGLT2 inhibitors. Serum electrolyte, water, and acid-base complications are also more common in patients with diabetic nephropathy. For example, type 4 (hyperkalemic, low–anion gap) renal tubular acidosis is more common in patients with type 2 DM, especially those with moderate renal insufficiency, and is associated with decreased ammoniagenesis.

It has also been noted that kidney stones may be more common in patients with type 2 DM, as well as metabolic syndrome. [48] The increased risk of stone disease is linked to insulin resistance, which, as a result of impaired ammoniagenesis, leads to a reduced urine pH. A low urine pH primarily favors uric acid stone formation; studies have found that female patients with type 2 DM, especially, have strikingly higher rates of uric acid stones. [49]

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