Diabetes and the kidney

Module 5: Diabetic kidney disease and other complications

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CME Credits: 1
Module duration: 1 hour
Launch date: Spring 2020 (version 1)
Updated: Spring 2023 (version 2)
Expiry date: March 2027
Audience: Diabetes and Metabolism Specialists (Subspeciality), Endocrinologists (Subspeciality), General Physicians (Advanced), Nephrologists (Advanced)

My name is Sally Marshall. I’m Professor of Diabetes at Newcastle University and Editor-in-Chief of the journal Diabetologia. An individual with diabetes and diabetic kidney disease is someone who, sadly, does not do well from all of the complications of diabetes. The life expectancy of an individual with diabetes and chronic kidney disease is shortened compared with the life expectancy of an individual with diabetes who does not have chronic kidney disease. In type 1 diabetes, someone with diabetic kidney disease will live on average for 12 years less than someone without kidney disease. In type 2 diabetes, the loss of life is four to five years. The main reason for this reduction in life expectancy is the excess of cardiovascular disease seen in individuals with diabetic kidney disease.

The presence and severity of kidney disease in people with diabetes identifies those who are at increased risk of adverse health outcomes and premature mortality. People with classical diabetic nephropathy are at greatly increased risk of the other microvascular and macrovascular complications of diabetes. The risk of cardiovascular disease (CVD) is particularly marked in individuals with diabetic kidney disease (DKD), regardless of cause, and the risk increases as albuminuria increases and independently as glomerular filtration rate (GFR) decreases. People with classical diabetic nephropathy invariably also have other microvascular complications. This module is designed to help you understand the relationship between DKD and the other major complications of diabetes.

Learning Outcomes

By the end of this module, you will be able to:

Explain the increased risk of macrovascular and microvascular disease associated with diabetic kidney disease (DKD) for people with type 1 diabetes

Explain the increased risk of macrovascular and microvascular disease associated with DKD for people with type 2 diabetes

Develop management plans for people with type 1 and type 2 diabetes and the complications associated with advanced stage chronic kidney disease


This module includes self-marked assessments, such as knowledge checks and/or case studies, as well as a marked final assessment, which you can attempt up to five times. To complete the module, you must review all chapters, pass the final assessment (80% pass mark), and fill in our feedback form.


Contributors

Professor
Sally Marshall
Author
Professor
Per-Henrik Groop
Expert Reviewer
Assessment Setter
Assessment Setter