CHAPTER 1: DIAGNOSIS OF DIABETES MELLITUS AND CHRONIC KIDNEY DISEASE
DOI:
https://doi.org/10.47196/diab.v58i2Sup.782Keywords:
chronic kidney disease, diabetes mellitusAbstract
Chronic kidney disease (CKD) is defined by the presence of alterations in kidney structure and/or function for a period of more than 3 months and with implications for health1,2.
The glomerular filtration rate (GFR) category is established in five stages (from E1 to E5); E3 is subdivided into E3a and E3b, depending on whether the GFR (GFR) is between 59 to 45 or between 44 to 30 mL/min/1.73 m2, respectively.
Additionally, albuminuria should be categorized for any degree of GFR. To simplify evaluation and prognosis, three categories of albuminuria were proposed: A1, A2, or A3, as appropriate: A1 <30, A2 30-300, or A3 >300 mg/g. The equivalences in mg/mmol are A1 <3, A2 3-30 and A3 >30, and in albuminuria in 24-hour urine (h) they are A1 <30, A2 30-300 and A3 >300 mg/24 hours.
The appropriate classification of CKD must consider the cause, the GFR categories (E1-E5) and in the absence of other markers of kidney damage, persistent urinary albumin excretion (A1-A2-A3).
References
I. Kidney Disease: Improving Global Outcomes CKD Work Group. KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2012;3:S1-S150.
II. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(suppl 2):S1-S266.
III. Chauhan A, Singhal A, Goyal P. TG/HDL Ratio: a marker for insulin resistance and atherosclerosis in prediabetics or not? J Family Med Prim Care 2021 Oct;10(10):3700-3705
IV. Standards of Care in Diabetes. 2023 Abridged for Primary Care Providers. American Diabetes Association. Clin Diabetes 2023;41(1):4-31.
V. Elbert A, Schreier L, Galli C, et al. Prevalence of impaired fasting glycemia, impaired glucose tolerance, and type 2 diabetes in hemodialyzed patients when applying new diagnostic criteria. J Ren Nutr 2006;16:300-303.
VI. Torres-Ramírez A, Rodríguez-Rodríguez AE, Porrini E. Diabetes tras el trasplante renal. En: Lorenzo V, López Gómez JM (Eds). Nefrología al día. ISSN: 2659-2606. Disponible en: https://www.nefrologiaaldia.org/298. Última actualización: junio 2023.
VII. Standards of Medical Care in Diabetes 2021. Diabetes Care 2021;44(Suppl.1):S15-S33.
VIII. Introduction: Standards of Medical Care in Diabetes 2022. Diabetes Care 2022;45(Suppl.1):S17-S38.
IX. Sridhar VS, Limonte CP, Groop PH, Heerspink HJL, Pratley RE, Rossing P, Skyler JS, Cherney DZI. Chronic kidney disease in type 1 diabetes: translation of novel type 2 diabetes therapeutics to individuals with type 1 diabetes. Diabetologia 2024 Jan;67(1):3-18. doi: 10.1007/s00125-023-06015-1.
X. Tuttle K, Bakris G, Bilous RW, et al; Diabetic Kidney Disease. A report from an ADA Consensus Conference. Diabetes Care 2014;37(10):2864-2883.
XI. Ebert N, Bevc S, Bökenkamp A, Gaillard F, Hornum M, Jager KJ, Mariat C, Eriksen BO, Palsson R, Rule AD, van Londen M, White C, Schaeffner E. Assessment of kidney function: clinical indications for measured GFR. Clin Kidney J 2021 Feb 22;14(8):1861-1870
XII. Stevens P, Levin A. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group KDIGO 2012. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2013;3:S1-S150.
XIII. Ruggenenti P, Porrini E, Motterlini N, Perna A, Ilieva AP, Iliev IP, Dodesini AR, Trevisan R, Bossi A, Sampietro G, Capitoni E, Gaspari F, Rubis N, Ene-Iordache B, Remuzzi G; BENEDICT Study Investigators. Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes. J Am Soc Nephrol 2012 Oct;23(10):1717-24.
XIV. Birkeland KI, Bodegard J. Heart failure and chronic kidney disease manifestation and mortality risk associations in type 2 diabetes: a large multinational cohort study. Diabetes Obes Metab 2020 Sep;22(9):1607-1618.
XV. Hussain S, Chowdhury TA. The impact of comorbidities on the pharmacological management of type 2 diabetes mellitus. Drugs 2019 Feb;79(3):231-242.
XVI. Murton M, Goff-Leggett D, Bobrowska A, et al. Burden of chronic kidney disease by KDIGO categories of glomerular filtration rate and albuminuria: a systematic review. Adv Ther. 2021 Jan;38(1):180-200.
XVII. Forbes A, Gallagher H. Chronic kidney disease in adults: assessment and management. Clinical Medicine 2020 Mar;20(2):128-132.
XVIII. Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022 Sep;18(9):525-539. doi: 10.1038/s41574-022-00690-7.
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