Conservative Management of Diabetic Kidney Disease

Progressive diabetic kidney disease (DKD) carries increased morbidity and mortality. Knowledge of the pathophysiological changes imparts management strategies. Underuse or overuse of hypoglycemic agents are a threat to patients well being. Inappropriate advice and other comorbidities such as cardiovascular disease, infections, dietary indiscretion, use of alternative medications, and nephrotoxic agents are implicated in the rapid progression of DKD. Cardiovascular disease protection and maintenance of euglycemia are important components of therapy in progressive CKD. Blood pressure control to below 130/80 mmHg should be a reasonable goal. Hypoglycemia should be prevented for cardiovascular and neurologic safety.