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Complications of diabetes: renal disease and promotion of self-management

Melville Johnson, 1 Osmond Terrace, Porthmadog, Gwynedd LL49 9AN, UK

R Richardson, research fellow, D Lister-Sharp, research fellow

NHS Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK

A McIntosh, research fellow

ScHARR, University of Sheffield, Sheffield S1 4DA, UK

Dr A Melville Arabella_Melville@port35.freeserve.co.uk October 18, 2000 .

This paper is an edited version of Effective Health Care volume 6 number 1,¹ which summarises information originally derived from systematic reviews undertaken to inform national clinical practice guidelines,²³ supplemented and re-analysed by the NHS Centre for Reviews and Dissemination.

Renal complications of type 2 diabetes

Raised blood glucose levels and related microvascular disease are associated with progressive damage to the kidneys. This damage becomes detectable when protein (primarily albumin) is excreted in the urine in higher concentrations than normal. As the severity of the damage increases, the quantity of protein in the urine also increases. When the level of albumin in the urine is fairly low, the condition is known as microalbuminuria or incipient nephropathy; higher albumin excretion is described as proteinuria. Eventually the condition can lead to renal failure.²

Epidemiological studies report prevalence rates of microalbuminuria in patients with type 2 diabetes ranging from 8% to 32% with most estimates being around 25%.^4–15 Prevalence . . . [Full text of this article]