In the ongoing series on diabetes mellitus, this article discusses an approach to screen and evaluate patients with diabetes for kidney disease and retinopathy. DIABETIC NEPHROPATHY: DIAGNOSIS, PREVENTION AND MANAGEMENT Nephropathy in a patient with diabetes mellitus is a common, serious and potentially life-threatening microvascular complication. Conventionally, ‘diabetic nephropathy’ is defined as ‘dipstick-positive proteinuria in a patient with long-standing diabetes, due to diabetic glomerulosclerosis, in the absence of other causes of proteinuria’. Proteinuria detectable by ‘dipstick’ examination implies a daily protein loss of >300 mg in the urine. Globally, diabetic nephropathy (DN) is the single most common cause of incident end-stage kidney disease (ESKD), accounting for 30%–40% of patients. The prevalence of DM in adults in metropolitan cities in India is >10%; of these about 30% are likely to develop DN (several million people!).
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