Diabetic kidney disease: a report from an ADA Consensus Conference

Katherine R Tuttle, George L Bakris, Rudolf W Bilous, Jane L Chiang, Ian H de Boer, Jordi Goldstein-Fuchs, Irl B Hirsch, Kamyar Kalantar-Zadeh, Andrew S Narva, Sankar D Navaneethan, Joshua J Neumiller, Uptal D Patel, Robert E Ratner, Adam T Whaley-Connell, Mark E Molitch, Katherine R Tuttle, George L Bakris, Rudolf W Bilous, Jane L Chiang, Ian H de Boer, Jordi Goldstein-Fuchs, Irl B Hirsch, Kamyar Kalantar-Zadeh, Andrew S Narva, Sankar D Navaneethan, Joshua J Neumiller, Uptal D Patel, Robert E Ratner, Adam T Whaley-Connell, Mark E Molitch

Abstract

The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included 1) identification and monitoring, 2) cardiovascular disease and management of dyslipidemia, 3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, 4) glycemia measurement, hypoglycemia, and drug therapies, 5) nutrition and general care in advanced-stage chronic kidney disease, 6) children and adolescents, and 7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.

© 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Figures

Figure 1
Figure 1
Risk of mortality in patients with diabetes and ESRD. A: Risk of mortality by initial A1C, adjusted for age, sex, race, BMI, years of dialysis, albumin, creatinine, 10 comorbid conditions, insulin use, hemoglobin, HDL cholesterol, country, and study phase. B: Risk of mortality by mean A1C, adjusted for age, sex, race, BMI, years of dialysis, albumin, creatinine, 10 comorbid conditions, insulin use, hemoglobin, HDL cholesterol, country, and study phase. Reproduced with permission from ADA (68).

References

    1. de Boer IH, Rue TC, Hall YN, Heagerty PJ, Weiss NS, Himmelfarb J. Temporal trends in the prevalence of diabetic kidney disease in the United States. JAMA 2011;305:2532–2539
    1. U.S. Renal Data System USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2013: 1.7.2; 1.8.2.
    1. U.S. Renal Data System USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2013:7.6.1; 7.9.1; 7.20.1.
    1. National Kidney Foundation KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis 2007;49(Suppl. 2)S12–S154
    1. Magee GM, Bilous RW, Cardwell CR, Hunter SJ, Kee F, Fogarty DG. Is hyperfiltration associated with the future risk of developing diabetic nephropathy? A meta-analysis. Diabetologia 2009;52:691–697
    1. Zatz R, Dunn BR, Meyer TW, Anderson S, Rennke HG, Brenner BM. Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. J Clin Invest 1986;77:1925–1930
    1. Evans M, Bain SC, Hogan S, Bilous RW, Collaborative Study Group Participants Irbesartan delays progression of nephropathy as measured by estimated glomerular filtration rate: post hoc analysis of the Irbesartan Diabetic Nephropathy Trial. Nephrol Dial Transplant 2012;27:2255–2263
    1. Holtkamp FA, de Zeeuw D, Thomas MC, et al. An acute fall in estimated glomerular filtration rate during treatment with losartan predicts a slower decrease in long-term renal function. Kidney Int 2011;80:282–287
    1. Bakris GL, Molitch M. Microalbuminuria as a risk predictor in diabetes: the continuing saga. Diabetes Care 2014;37:867–875
    1. Bilous R. Microvascular disease: what does the UKPDS tell us about diabetic nephropathy? Diabet Med 2008;25(Suppl. 2):25–29
    1. Nosadini R, Velussi M, Brocco E, et al. Course of renal function in type 2 diabetic patients with abnormalities of albumin excretion rate. Diabetes 2000;49:476–484
    1. MacIsaac RJ, Tsalamandris C, Panagiotopoulos S, Smith TJ, McNeil KJ, Jerums G. Nonalbuminuric renal insufficiency in type 2 diabetes. Diabetes Care 2004;27:195–200
    1. He F, Xia X, Wu XF, Yu XQ, Huang FX. Diabetic retinopathy in predicting diabetic nephropathy in patients with type 2 diabetes and renal disease: a meta-analysis. Diabetologia 2013;56:457–466
    1. Bachmann LM, Nilsson G, Bruns DE, et al. State of the art for measurement of urine albumin: comparison of routine measurement procedures to isotope dilution tandem mass spectrometry. Clin Chem 2014;60:471–480
    1. Heart Outcomes Prevention Evaluation Study Investigators Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000;355:253–259
    1. Patel A, MacMahon S, Chalmers J, et al. ADVANCE Collaborative Group Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008;358:2560–2572
    1. Bilous RW, Parving H-H, Orchard TJ, et al. Renin angiotensin system blockade is effective in preventing microalbuminuria in hypertensive but not normotensive people with type 2 diabetes; further analysis of the DIRECT Programme [Internet]. Stockholm, Sweden, EASD, 2010
    1. Saydah SH, Pavkov ME, Zhang C, et al. Albuminuria prevalence in first morning void compared with previous random urine from adults in the National Health and Nutrition Examination Survey, 2009-2010. Clin Chem 2013;59:675–683
    1. Perkins BA, Ficociello LH, Silva KH, Finkelstein DM, Warram JH, Krolewski AS. Regression of microalbuminuria in type 1 diabetes. N Engl J Med 2003;348:2285–2293
    1. American Diabetes Association Standards of medical care in diabetes—2014. Diabetes Care 2014;37(Suppl. 1):S14–S80
    1. National Kidney Disease Education Program NKDEP [Internet]. Bethesda, MD, National Institutes of Health. Available from Accessed 19 May 2014
    1. 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
    1. Ismail-Beigi F, Craven T, Banerji MA, et al. ACCORD trial group Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet 2010;376:419–430
    1. Rossing P. Prediction, progression and prevention of diabetic nephropathy. The Minkowski Lecture 2005. Diabetologia 2006;49:11–19
    1. Qaseem A, Hopkins RH, Jr, Sweet DE, Starkey M, Shekelle P, Clinical Guidelines Committee of the American College of Physicians Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med 2013;159:835–847
    1. Fox CS, Matsushita K, Woodward M, et al. Chronic Kidney Disease Prognosis Consortium Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet 2012;380:1662–1673
    1. Tonelli M, Muntner P, Lloyd A, et al. Alberta Kidney Disease Network Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet 2012;380:807–814
    1. Groop P-H, Thomas MC, Moran JL, et al. FinnDiane Study Group The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes 2009;58:1651–1658
    1. Afkarian M, Sachs MC, Kestenbaum B, et al. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol 2013;24:302–308
    1. Borch-Johnsen K, Andersen PK, Deckert T. The effect of proteinuria on relative mortality in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1985;28:590–596
    1. Tonelli M, Muntner P, Lloyd A, et al. Alberta Kidney Disease Network Association between LDL-C and risk of myocardial infarction in CKD. J Am Soc Nephrol 2013;24:979–986
    1. Palmer SC, Craig JC, Navaneethan SD, Tonelli M, Pellegrini F, Strippoli GFM. Benefits and harms of statin therapy for persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med 2012;157:263–275
    1. Haynes R, Lewis D, Emberson J, et al. Effects of lowering LDL cholesterol on progression of kidney disease. J Am Soc Nephrol. 8 May 2014. [Epub ahead of print]
    1. Wanner C, Tonelli M, Cass A, et al. KDIGO clinical practice guideline for lipid management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int2014;85:1303−1309
    1. Holdaas H, Fellström B, Cole E, et al. Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators Long-term cardiac outcomes in renal transplant recipients receiving fluvastatin: the ALERT extension study. Am J Transplant 2005;5:2929–2936
    1. Jun M, Zhu B, Tonelli M, et al. Effects of fibrates in kidney disease: a systematic review and meta-analysis. J Am Coll Cardiol 2012;60:2061–2071
    1. Ansquer J-C, Dalton RN, Caussé E, Crimet D, Le Malicot K, Foucher C. Effect of fenofibrate on kidney function: a 6-week randomized crossover trial in healthy people. Am J Kidney Dis 2008;51:904–913
    1. Wheeler DC, Becker GJ. Summary of KDIGO guideline. What do we really know about management of blood pressure in patients with chronic kidney disease? Kidney Int 2013;83:377–383
    1. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507–520
    1. Taler SJ, Agarwal R, Bakris GL, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis 2013;62:201–213
    1. Pogue V, Rahman M, Lipkowitz M, et al. African American Study of Kidney Disease and Hypertension Collaborative Research Group Disparate estimates of hypertension control from ambulatory and clinic blood pressure measurements in hypertensive kidney disease. Hypertension 2009;53:20–27
    1. Messerli FH, Mancia G, Conti CR, et al. Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006;144:884–893
    1. Peralta CA, Norris KC, Li S, et al. KEEP Investigators Blood pressure components and end-stage renal disease in persons with chronic kidney disease: the Kidney Early Evaluation Program (KEEP). Arch Intern Med 2012;172:41–47
    1. Kovesdy CP, Bleyer AJ, Molnar MZ, et al. Blood pressure and mortality in U.S. veterans with chronic kidney disease: a cohort study. Ann Intern Med 2013;159:233–242
    1. Wake Forest Baptist Health Systolic Blood Pressure Intervention Trial. In: [Internet]. Bethesda, MD, National Library of Medicine, 2010. Available from Accessed 19 May 2014
    1. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD, The Collaborative Study Group The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med 1993;329:1456–1462
    1. Brenner BM, Cooper ME, de Zeeuw D, et al. RENAAL Study Investigators Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001;345:861–869
    1. Lewis EJ, Hunsicker LG, Clarke WR, et al. Collaborative Study Group Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001;345:851–860
    1. Fried LF, Emanuele N, Zhang JH, et al. VA NEPHRON-D Investigators Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med 2013;369:1892–1903
    1. Parving H-H, Brenner BM, McMurray JJV, et al. ALTITUDE Investigators Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med 2012;367:2204–2213
    1. Mann JFE, Schmieder RE, McQueen M, et al. ONTARGET investigators Renal Outcomes With Telmisartan, Ramipril, or Both, in People at High Vascular Risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial. Lancet 2008;372:547–553
    1. European Medicines Agency. Renin-angiotensin-system (RAS)-acting agents [Internet]. Available from Accessed 19 May 2014
    1. Mehdi UF, Adams-Huet B, Raskin P, Vega GL, Toto RD. Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy. J Am Soc Nephrol 2009;20:2641–2650
    1. Pitt B, Bakris G, Ruilope LM, DiCarlo L, Mukherjee R, EPHESUS Investigators Serum potassium and clinical outcomes in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Circulation 2008;118:1643–1650
    1. Toto RD. RAS blockade, hyperkalemia and AKI—look and you will find. Nat Rev Nephrol 2012;8:257–258
    1. Kohan DE, Pritchett Y, Molitch M, et al. Addition of atrasentan to renin-angiotensin system blockade reduces albuminuria in diabetic nephropathy. J Am Soc Nephrol 2011;22:763–772
    1. AbbVie. A Randomized, Multicountry, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of Atrasentan on Renal Outcomes in Subjects With Type 2 Diabetes and Nephropathy SONAR: Study of Diabetic Nephropathy With Atrasentan. In: [Internet]. Bethesda, MD, National Library of Medicine, 2013. Available from Accessed 19 May 2014
    1. Briasoulis A, Bakris G. The future of interventional management of hypertension: threats and opportunities. Curr Vasc Pharmacol 2014;12:69–76
    1. Bhatt DL, Kandzari DE, O’Neill WW, et al. SYMPLICITY HTN-3 Investigators A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014;370:1393–1401
    1. Bisognano JD, Bakris G, Nadim MK, et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from the double-blind, randomized, placebo-controlled rheos pivotal trial. J Am Coll Cardiol 2011;58:765–773
    1. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ, A1c-Derived Average Glucose Study Group Translating the A1C assay into estimated average glucose values. Diabetes Care 2008;31:1473–1478
    1. Ansari A, Thomas S, Goldsmith D. Assessing glycemic control in patients with diabetes and end-stage renal failure. Am J Kidney Dis 2003;41:523–531
    1. Vos FE, Schollum JB, Coulter CV, Doyle TCA, Duffull SB, Walker RJ. Red blood cell survival in long-term dialysis patients. Am J Kidney Dis 2011;58:591–598
    1. Nakao T, Matsumoto H, Okada T, et al. Influence of erythropoietin treatment on hemoglobin A1c levels in patients with chronic renal failure on hemodialysis. Intern Med 1998;37:826–830
    1. Miller ME, Bonds DE, Gerstein HC, et al. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study. BMJ 2010;340:b5444.
    1. Shurraw S, Hemmelgarn B, Lin M, et al. Alberta Kidney Disease Network Association between glycemic control and adverse outcomes in people with diabetes mellitus and chronic kidney disease: a population-based cohort study. Arch Intern Med 2011;171:1920–1927
    1. Kalantar-Zadeh K. A critical evaluation of glycated protein parameters in advanced nephropathy: a matter of life or death: A1C remains the gold standard outcome predictor in diabetic dialysis patients. Diabetes Care 2012;35:1625–1628
    1. Ramirez SPB, McCullough KP, Thumma JR, et al. Hemoglobin A(1c) levels and mortality in the diabetic hemodialysis population: findings from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Diabetes Care 2012;35:2527–2532
    1. Kim WJ, Park C-Y, Lee K-B, et al. Serum 1,5-anhydroglucitol concentrations are a reliable index of glycemic control in type 2 diabetes with mild or moderate renal dysfunction. Diabetes Care 2012;35:281–286
    1. Inaba M, Okuno S, Kumeda Y, et al. Osaka CKD Expert Research Group Glycated albumin is a better glycemic indicator than glycated hemoglobin values in hemodialysis patients with diabetes: effect of anemia and erythropoietin injection. J Am Soc Nephrol 2007;18:896–903
    1. Freedman BI, Andries L, Shihabi ZK, et al. Glycated albumin and risk of death and hospitalizations in diabetic dialysis patients. Clin J Am Soc Nephrol 2011;6:1635–1643
    1. Gerich JE, Meyer C, Woerle HJ, Stumvoll M. Renal gluconeogenesis: its importance in human glucose homeostasis. Diabetes Care 2001;24:382–391
    1. National Kidney Foundation KDOQI clinical practice guideline for diabetes and CKD: 2012 update. Am J Kidney Dis 2012;60:850–886
    1. Mühlhauser I, Toth G, Sawicki PT, Berger M. Severe hypoglycemia in type I diabetic patients with impaired kidney function. Diabetes Care 1991;14:344–346
    1. Scheen AJ. Pharmacokinetic considerations for the treatment of diabetes in patients with chronic kidney disease. Expert Opin Drug Metab Toxicol 2013;9:529–550
    1. Charpentier G, Riveline JP, Varroud-Vial M. Management of drugs affecting blood glucose in diabetic patients with renal failure. Diabetes Metab 2000;26(Suppl. 4):73–85
    1. Burrows NR, Li Y, Geiss LS. Incidence of treatment for end-stage renal disease among individuals with diabetes in the U.S. continues to decline. Diabetes Care 2010;33:73–77
    1. Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR, UKPDS Group Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 2003;63:225–232
    1. Zammitt NN, Frier BM. Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. Diabetes Care 2005;28:2948–2961
    1. Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP, Jr, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA 2009;301:1565–1572
    1. Ismail-Beigi F, Moghissi E, Tiktin M, Hirsch IB, Inzucchi SE, Genuth S. Individualizing glycemic targets in type 2 diabetes mellitus: implications of recent clinical trials. Ann Intern Med 2011;154:554–559
    1. Roberts F, Ryan GJ. The safety of metformin in heart failure. Ann Pharmacother 2007;41:642–646
    1. Lipska KJ, Bailey CJ, Inzucchi SE. Use of metformin in the setting of mild-to-moderate renal insufficiency. Diabetes Care 2011;34:1431–1437
    1. Metformin ok in CKD? Drug Ther Bull 2014;52:37.
    1. Kalantar-Zadeh K, Uppot RN, Lewandrowski KB. Case records of the Massachusetts General Hospital. Case 23-2013. A 54-year-old woman with abdominal pain, vomiting, and confusion. N Engl J Med 2013;369:374–382
    1. Salpeter SR, Greyber E, Pasternak GA, Salpeter EE. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev 2010;4:CD002967.
    1. Rachmani R, Slavachevski I, Levi Z, Zadok B, Kedar Y, Ravid M. Metformin in patients with type 2 diabetes mellitus: reconsideration of traditional contraindications. Eur J Intern Med 2002;13:428.
    1. Rydberg T, Jönsson A, Røder M, Melander A. Hypoglycemic activity of glyburide (glibenclamide) metabolites in humans. Diabetes Care 1994;17:1026–1030
    1. Holstein A, Plaschke A, Egberts EH. Lower incidence of severe hypoglycaemia in patients with type 2 diabetes treated with glimepiride versus glibenclamide. Diabetes Metab Res Rev 2001;17:467–473
    1. Harrower AD. Pharmacokinetics of oral antihyperglycaemic agents in patients with renal insufficiency. Clin Pharmacokinet 1996;31:111–119
    1. Balant L, Zahnd G, Gorgia A, Schwarz R, Fabre J. Pharmacokinetics of glipizide in man: influence of renal insufficiency. Diabetologia 1973;9(Suppl. 1):331–338
    1. Nagai T, Imamura M, Iizuka K, Mori M. Hypoglycemia due to nateglinide administration in diabetic patient with chronic renal failure. Diabetes Res Clin Pract 2003;59:191–194
    1. Hasslacher C, Multinational Repaglinide Renal Study Group Safety and efficacy of repaglinide in type 2 diabetic patients with and without impaired renal function. Diabetes Care 2003;26:886–891
    1. Budde K, Neumayer H-H, Fritsche L, Sulowicz W, Stompôr T, Eckland D. The pharmacokinetics of pioglitazone in patients with impaired renal function. Br J Clin Pharmacol 2003;55:368–374
    1. Chapelsky MC, Thompson-Culkin K, Miller AK, Sack M, Blum R, Freed MI. Pharmacokinetics of rosiglitazone in patients with varying degrees of renal insufficiency. J Clin Pharmacol 2003;43:252–259
    1. Thompson-Culkin K, Zussman B, Miller AK, Freed MI. Pharmacokinetics of rosiglitazone in patients with end-stage renal disease. J Int Med Res 2002;30:391–399
    1. Grey AB. Skeletal toxicity of thiazolidinediones. Ann Intern Med 2008;148:563.
    1. U.S. Food and Drug Administration. Drug safety information for healthcare professionals—information for healthcare professionals: reports of altered kidney function in patients using exenatide (marketed as Byetta) [Internet]. Washington, DC, U.S. Food and Drug Administration, 2009. Available from Accessed 19 May 2014
    1. Tuttle KR, Heilmann C, Hoogwerf BJ, Brown C, Anderson PW. Effects of exenatide on kidney function, adverse events, and clinical end points of kidney disease in type 2 diabetes. Am J Kidney Dis 2013;62:396–398
    1. Pawaskar M, Tuttle KR, Li Q, Best JH, Anderson PW. Observational study of kidney function and albuminuria in patients with type 2 diabetes treated with exenatide BID versus insulin glargine. Ann Pharmacother 2014;48:571–576
    1. Davidson JA, Brett J, Falahati A, Scott D. Mild renal impairment and the efficacy and safety of liraglutide. Endocr Pract 2011;17:345–355
    1. Pendergrass M, Fenton C, Haffner SM, Chen W. Exenatide and sitagliptin are not associated with increased risk of acute renal failure: a retrospective claims analysis. Diabetes Obes Metab 2012;14:596–600
    1. Deacon CF, Mannucci E, Ahrén B. Glycaemic efficacy of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors as add-on therapy to metformin in subjects with type 2 diabetes-a review and meta analysis. Diabetes Obes Metab 2012;14:762–767
    1. Aroda VR, Henry RR, Han J, et al. Efficacy of GLP-1 receptor agonists and DPP-4 inhibitors: meta-analysis and systematic review. Clin Ther 2012;34:1247–1258.e22
    1. Giorda CB, Nada E, Tartaglino B. Pharmacokinetics, safety, and efficacy of DPP-4 inhibitors and GLP-1 receptor agonists in patients with type 2 diabetes mellitus and renal or hepatic impairment. A systematic review of the literature [published correction appears in Endocrine 2014;46:420−22]. Endocrine 2014;46:406−419
    1. Januvia (sitagliptin) [package insert] Whitehouse Station, NJ, Merck & Co. Inc., February 2014
    1. Onglyza (saxagliptin) [package insert] Princeton, NJ, Bristol-Myers Squibb Co, May 2013
    1. Nesina (alogliptin) [package insert] Deerfield, IL, Takeda Pharmaceuticals American, Inc, June 2013
    1. Tradjenta (linagliptin) [package insert] Ridgefield, CT, Boehringer Ingelheim Pharmaceuticals, Inc, May 2014
    1. Friedrich C, Emser A, Woerle H-J, Graefe-Mody U. Renal impairment has no clinically relevant effect on the long-term exposure of linagliptin in patients with type 2 diabetes. Am J Ther 2013;20:618–621
    1. Kim YG, Hahn S, Oh TJ, Kwak SH, Park KS, Cho YM. Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis. Diabetologia 2013;56:696–708
    1. Neumiller JJ, White JR, Jr, Campbell RK. Sodium-glucose co-transport inhibitors: progress and therapeutic potential in type 2 diabetes mellitus. Drugs 2010;70:377–385
    1. Kohan DE, Fioretto P, Tang W, List JF. Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control. Kidney Int 2014;85:962–971
    1. Yale J-F, Bakris G, Cariou B, et al. Efficacy and safety of canagliflozin in subjects with type 2 diabetes and chronic kidney disease. Diabetes Obes Metab 2013;15:463–473
    1. Cherney DZI, Perkins BA, Soleymanlou N, et al. Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus. Circulation 2014;129:587–597
    1. Meloni C, Morosetti M, Suraci C, et al. Severe dietary protein restriction in overt diabetic nephropathy: benefits or risks? J Ren Nutr 2002;12:96–101
    1. Wrone EM, Carnethon MR, Palaniappan L, Fortmann SP, Third National Health and Nutrition Examination Survey Association of dietary protein intake and microalbuminuria in healthy adults: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003;41:580–587
    1. Hoogeveen EK, Kostense PJ, Jager A, et al. Serum homocysteine level and protein intake are related to risk of microalbuminuria: the Hoorn Study. Kidney Int 1998;54:203–209
    1. Knight EL, Stampfer MJ, Hankinson SE, Spiegelman D, Curhan GC. The impact of protein intake on renal function decline in women with normal renal function or mild renal insufficiency. Ann Intern Med 2003;138:460–467
    1. Bernstein AM, Sun Q, Hu FB, Stampfer MJ, Manson JE, Willett WC. Major dietary protein sources and risk of coronary heart disease in women. Circulation 2010;122:876–883
    1. Cirillo M, Lombardi C, Chiricone D, De Santo NG, Zanchetti A, Bilancio G. Protein intake and kidney function in the middle-age population: contrast between cross-sectional and longitudinal data. Nephrol Dial Transplant. 21 March 2014 [Epub ahead of print]
    1. Estruch R, Ros E, Salas-Salvadó J, et al. PREDIMED Study Investigators Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013;368:1279–1290
    1. Sacks FM, Obarzanek E, Windhauser MM, et al. Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol 1995;5:108–118
    1. Odermatt A. The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease. Am J Physiol Renal Physiol 2011;301:F919–F931
    1. Goldstein-Fuchs DJ, LaPierra AF. Nutrition and Kidney Disease. National Kidney Foundation. National Kidney Foundation’s primer on kidney diseases. 6th ed. Gilbert SJ, Weiner DE, Gipson DS, Perazella MA, Tonelli M, Eds. Philadelphia, PA, Elsevier/Saunders, 2014, p. 467–475
    1. Pijls LTJ, de Vries H, van Eijk JTM, Donker AJM. Protein restriction, glomerular filtration rate and albuminuria in patients with type 2 diabetes mellitus: a randomized trial. Eur J Clin Nutr 2002;56:1200–1207
    1. Dussol B, Iovanna C, Raccah D, et al. A randomized trial of low-protein diet in type 1 and in type 2 diabetes mellitus patients with incipient and overt nephropathy. J Ren Nutr 2005;15:398–406
    1. Pedrini MT, Levey AS, Lau J, Chalmers TC, Wang PH. The effect of dietary protein restriction on the progression of diabetic and nondiabetic renal diseases: a meta-analysis. Ann Intern Med 1996;124:627–632
    1. Robertson L, Waugh N, Robertson A. Protein restriction for diabetic renal disease. Cochrane Database Syst Rev 2007;4:CD002181.
    1. Hansen HP, Christensen PK, Tauber-Lassen E, Klausen A, Jensen BR, Parving HH. Low-protein diet and kidney function in insulin-dependent diabetic patients with diabetic nephropathy. Kidney Int 1999;55:621–628
    1. Kasiske BL, Lakatua JD, Ma JZ, Louis TA. A meta-analysis of the effects of dietary protein restriction on the rate of decline in renal function. Am J Kidney Dis 1998;31:954–961
    1. Raal FJ, Kalk WJ, Lawson M, et al. Effect of moderate dietary protein restriction on the progression of overt diabetic nephropathy: a 6-mo prospective study. Am J Clin Nutr 1994;60:579–585
    1. Dullaart RP, Beusekamp BJ, Meijer S, van Doormaal JJ, Sluiter WJ. Long-term effects of protein-restricted diet on albuminuria and renal function in IDDM patients without clinical nephropathy and hypertension. Diabetes Care 1993;16:483–492
    1. Hansen HP, Tauber-Lassen E, Jensen BR, Parving H-H. Effect of dietary protein restriction on prognosis in patients with diabetic nephropathy. Kidney Int 2002;62:220–228
    1. Pan Y, Guo LL, Jin HM. Low-protein diet for diabetic nephropathy: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2008;88:660–666
    1. Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2014;37(Suppl. 1):S120–S143
    1. Shapiro H, Theilla M, Attal-Singer J, Singer P. Effects of polyunsaturated fatty acid consumption in diabetic nephropathy. Nat Rev Nephrol 2011;7:110–121
    1. Lee CC, Sharp SJ, Wexler DJ, Adler AI. Dietary intake of eicosapentaenoic and docosahexaenoic acid and diabetic nephropathy: cohort analysis of the diabetes control and complications trial. Diabetes Care 2010;33:1454–1456
    1. Kovesdy CP, Sharma K, Kalantar-Zadeh K. Glycemic control in diabetic CKD patients: where do we stand? Am J Kidney Dis 2008;52:766–777
    1. Kalantar-Zadeh K, Abbott KC, Kronenberg F, Anker SD, Horwich TB, Fonarow GC. Epidemiology of dialysis patients and heart failure patients. Semin Nephrol 2006;26:118–133
    1. Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney Int 2003;63:793–808
    1. Kalantar-Zadeh K. What is so bad about reverse epidemiology anyway? Semin Dial 2007;20:593–601
    1. Kalantar-Zadeh K. Causes and consequences of the reverse epidemiology of body mass index in dialysis patients. J Ren Nutr 2005;15:142–147
    1. Kalantar-Zadeh K, Anker SD, Coats AJS, Horwich TB, Fonarow GC. Obesity paradox as a component of reverse epidemiology in heart failure. Arch Intern Med 2005;165:1797; author reply 1797–1798
    1. Kalantar-Zadeh K, Kilpatrick RD, Kuwae N, Wu DY. Reverse epidemiology: a spurious hypothesis or a hardcore reality? Blood Purif 2005;23:57–63
    1. Kalantar-Zadeh K, Kilpatrick RD, McAllister CJ, Greenland S, Kopple JD. Reverse epidemiology of hypertension and cardiovascular death in the hemodialysis population: the 58th annual fall conference and scientific sessions. Hypertension 2005;45:811–817
    1. Schumock GT, Andress DL, Marx SE, Sterz R, Joyce AT, Kalantar-Zadeh K. Association of secondary hyperparathyroidism with CKD progression, health care costs and survival in diabetic predialysis CKD patients. Nephron Clin Pract 2009;113:c54–c61
    1. Rhee CM, Leung AM, Kovesdy CP, Lynch KE, Brent GA, Kalantar-Zadeh K. Updates on the management of diabetes in dialysis patients. Semin Dial 2014;27:135–145
    1. Park J, Lertdumrongluk P, Molnar MZ, Kovesdy CP, Kalantar-Zadeh K. Glycemic control in diabetic dialysis patients and the burnt-out diabetes phenomenon. Curr Diab Rep 2012;12:432–439
    1. Kalantar-Zadeh K, Derose SF, Nicholas S, Benner D, Sharma K, Kovesdy CP. Burnt-out diabetes: impact of chronic kidney disease progression on the natural course of diabetes mellitus. J Ren Nutr 2009;19:33–37
    1. Ricks J, Molnar MZ, Kovesdy CP, et al. Glycemic control and cardiovascular mortality in hemodialysis patients with diabetes: a 6-year cohort study. Diabetes 2012;61:708–715
    1. Kalantar-Zadeh K, Kopple JD, Regidor DL, et al. A1C and survival in maintenance hemodialysis patients. Diabetes Care 2007;30:1049–1055
    1. Hoshino J, Mehrotra R, Rhee CM, et al. Using hemoglobin A1c to derive mean blood glucose in peritoneal dialysis patients. Am J Nephrol 2013;37:413–420
    1. Duong U, Mehrotra R, Molnar MZ, et al. Glycemic control and survival in peritoneal dialysis patients with diabetes mellitus. Clin J Am Soc Nephrol 2011;6:1041–1048
    1. Molnar MZ, Kovesdy CP, Bunnapradist S, et al. Associations of pretransplant serum albumin with post-transplant outcomes in kidney transplant recipients. Am J Transplant 2011;11:1006–1015
    1. Sarno G, Mehta RJ, Guardado-Mendoza R, Jimenez-Ceja LM, De Rosa P, Muscogiuri G. New-onset diabetes mellitus: predictive factors and impact on the outcome of patients undergoing liver transplantation. Curr Diabetes Rev 2013;9:78–85
    1. Chakkera HA, Mandarino LJ. Calcineurin inhibition and new-onset diabetes mellitus after transplantation. Transplantation 2013;95:647–652
    1. Chakkera HA, Weil EJ, Pham P-T, Pomeroy J, Knowler WC. Can new-onset diabetes after kidney transplant be prevented? Diabetes Care 2013;36:1406–1412
    1. TODAY Study Group Rapid rise in hypertension and nephropathy in youth with type 2 diabetes: the TODAY clinical trial. Diabetes Care 2013;36:1735–1741
    1. Marcovecchio ML, Woodside J, Jones T, et al. AdDIT Investigators Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): urinary screening and baseline biochemical and cardiovascular assessments. Diabetes Care 2014;37:805–813
    1. Demirel F, Tepe D, Kara O, Esen I. Microvascular complications in adolescents with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol 2013;5:145–149
    1. American Diabetes Association Economic costs of diabetes in the U.S. in 2012. Diabetes Care 2013;36:1033–1046
    1. Pettitt DJ, Talton J, Dabelea D, et al. SEARCH for Diabetes in Youth Study Group Prevalence of diabetes in U.S. youth in 2009: the SEARCH for Diabetes in Youth Study. Diabetes Care 2014;37:402–408
    1. Dabelea D, Mayer-Davis EJ, Saydah S, et al. SEARCH for Diabetes in Youth Study Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 2014;311:1778–1786
    1. Gaede P, Lund-Andersen H, Parving H-H, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 2008;358:580–591
    1. Gaede P, Vedel P, Larsen N, Jensen GVH, Parving H-H, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 2003;348:383–393
    1. Shankar A, Klein R, Klein BEK. The association among smoking, heavy drinking, and chronic kidney disease. Am J Epidemiol 2006;164:263–271
    1. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PWF, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 2004;291:844–850
    1. Robinson-Cohen C, Katz R, Mozaffarian D, et al. Physical activity and rapid decline in kidney function among older adults. Arch Intern Med 2009;169:2116–2123
    1. Chen P-Y, Huang Y-C, Kao Y-H, Chen J-Y. Effects of an exercise program on blood biochemical values and exercise stage of chronic kidney disease patients. J Nurs Res 2010;18:98–107
    1. Wang Y, Chen X, Song Y, Caballero B, Cheskin LJ. Association between obesity and kidney disease: a systematic review and meta-analysis. Kidney Int 2008;73:19–33
    1. Morales E, Valero MA, León M, Hernández E, Praga M. Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies. Am J Kidney Dis 2003;41:319–327
    1. Chan JC, So W-Y, Yeung C-Y, et al. SURE Study Group Effects of structured versus usual care on renal endpoint in type 2 diabetes: the SURE study: a randomized multicenter translational study. Diabetes Care 2009;32:977–982
    1. Leung WYS, So W-Y, Tong PCY, Chan NN, Chan JCN. Effects of structured care by a pharmacist-diabetes specialist team in patients with type 2 diabetic nephropathy. Am J Med 2005;118:1414.
    1. Olivarius NF, Beck-Nielsen H, Andreasen AH, Hørder M, Pedersen PA. Randomised controlled trial of structured personal care of type 2 diabetes mellitus. BMJ 2001;323:970–975
    1. Rossi MCE, Nicolucci A, Arcangeli A, et al. Associazione Medici Diabetologi Annals Study Group Baseline quality-of-care data from a quality-improvement program implemented by a network of diabetes outpatient clinics. Diabetes Care 2008;31:2166–2168
    1. Agency for Healthcare Research and Quality. Patient Self-Management Support Programs An Evaluation [Internet], 2007. Available from Accessed 19 May 2014
    1. World Health Organization Adherence to Long-Term Therapies: Evidence for Action. Sabaté E, Ed. Geneva, World Health Organization, 2003, p. 198
    1. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2006;23:1165–1173
    1. Palmer S, Vecchio M, Craig JC, et al. Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. Kidney Int 2013;84:179–191
    1. Renders CM, Valk GD, Griffin SJ, Wagner EH, Eijk Van JT, Assendelft WJ. Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. Diabetes Care 2001;24:1821–1833
    1. Shojania KG, Ranji SR, McDonald KM, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA 2006;296:427–440
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Lipid Work Group KDIGO clinical practice guideline for lipid management in chronic kidney disease. Kidney Int 2013;3 (Suppl.):259–305
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int 2012;2(Suppl.):337–414
    1. Mitchell P, Wynia M, Golden R, et al. Core principles & values of effective team-based health care [Internet], 2012. Washington, DC, Institute of Medicine. Available from Accessed 19 May 2014
    1. Lee BJ, Forbes K. The role of specialists in managing the health of populations with chronic illness: the example of chronic kidney disease. BMJ 2009;339:b2395.
    1. Lee B, Turley M, Meng D, et al. Effects of proactive population-based nephrologist oversight on progression of chronic kidney disease: a retrospective control analysis. BMC Health Serv Res 2012;12:252.
    1. Bayliss EA, Bhardwaja B, Ross C, Beck A, Lanese DM. Multidisciplinary team care may slow the rate of decline in renal function. Clin J Am Soc Nephrol 2011;6:704–710
    1. Bojadzievski T, Gabbay RA. Patient-centered medical home and diabetes. Diabetes Care 2011;34:1047–1053
    1. Abe M, Okada K, Maruyama T, Maruyama N, Soma M, Matsumoto K. Clinical effectiveness and safety evaluation of long-term pioglitazone treatment for erythropoietin responsiveness and insulin resistance in type 2 diabetic patients on hemodialysis. Expert Opin Pharmacother 2010;11:1611–1620

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