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Diabetic Kidney Disease

Daphne H. Knicely, M.D., Donna Myers, M.D.
Diabetic Kidney Disease is a topic covered in the Johns Hopkins Diabetes Guide.

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  • Diabetic kidney disease (DKD) is one of the common long-term, microvascular complications of diabetes.
  • DKD remains the most common cause of end-stage renal disease (ESRD), accounting for about half of all ESRD cases.[72]
  • Characterized initially by moderately increased urine albumin-to-creatinine ratio (UACR), formerly called "microalbuminuria" (30-300 mg albumin/g creatinine); then severely increased UACR, formerly called "macroalbuminuria" (>300 mg albumin/g creatinine); followed by renal insufficiency as evidenced by elevated BUN and creatinine; and finally ESRD.[1][2]
  • Histologic findings in DKD include basement membrane thickening, mesangial expansion, nodular glomerulosclerosis with classic Kimmelstein-Wilson nodules (late finding), specific vascular lesions including arterial hyalinosis, and tubulointerstitial changes such as development of fibrosis. Ultimately, this results in progressive albuminuria, reduction in glomerular filtration rate (GFR), elevation of arterial blood pressure and fluid retention.[20][17]

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Last updated: March 3, 2019


Knicely, Daphne H, and Donna Myers. "Diabetic Kidney Disease." Johns Hopkins Diabetes Guide, 2019. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547097/all/Diabetic_Kidney_Disease.
Knicely DH, Myers D. Diabetic Kidney Disease. Johns Hopkins Diabetes Guide. 2019. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547097/all/Diabetic_Kidney_Disease. Accessed July 16, 2019.
Knicely, D. H., & Myers, D. (2019). Diabetic Kidney Disease. In Johns Hopkins Diabetes Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547097/all/Diabetic_Kidney_Disease
Knicely DH, Myers D. Diabetic Kidney Disease [Internet]. In: Johns Hopkins Diabetes Guide. ; 2019. [cited 2019 July 16]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547097/all/Diabetic_Kidney_Disease.
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TY - ELEC T1 - Diabetic Kidney Disease ID - 547097 A1 - Knicely,Daphne,M.D. AU - Myers,Donna,M.D. Y1 - 2019/03/03/ BT - Johns Hopkins Diabetes Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547097/all/Diabetic_Kidney_Disease DB - Johns Hopkins Guide DP - Unbound Medicine ER -