Diabetic Nephropathy

The Division of Nephrology and Hypertension is pleased to announce the establishment of the Mayo Clinic Diabetic Nephropathy Clinic (DNC). Diabetic nephropathy presently accounts for fifty percent of all new cases of End Stage Renal Disease (ESRD) each year.

The majority of ESRD cases arise in patients with Type 2 diabetes who initially present with microalbuminuria and hypertension.

Of note, however, at least 30% of patients with both Type 2 diabetes and renal insufficiency have neither proteinuria nor diabetic retinopathy. In these patients, other causes of renal insufficiency such as ischemic renovascular disease, atheroembolism, nephrotoxin exposures, or other glomerular diseases need to considered. Several studies have demonstrated that aggressive blood pressure control using angiotensin converting enzyme-inhibitors and/or angiotensin receptor blockers can prevent or delay the progression of diabetic nephropathy. Other risk factor interventions such as blood glucose control and treatment of dyslipidemia are also helpful. Towards achieving this goal, a collaborative effort between the Divisions of Endocrinology/Metabolism and Nephrology/Hypertension has been undertaken. The mission of the DNC is to identify early and aggressively manage renal disease in the diabetic patient (and to exclude other causes of renal disease). Another important mission of this collaboration is to foster clinical and basic research in the area of diabetic nephropathy.

Referral criteria are the following:

  • Any diabetic patient with proteinuria, regardless of blood pressure status
  • Any diabetic patient with renal insufficiency regardless of the presence or absence of hypertension or proteinuria