Glucose-lowering therapies in patients with diabetes mellitus and chronic kidney disease

Abstract

Expansion of diabetic population (predominantly due to type 2 diabetes mellitus) with chronic kidney disease (CKD) comorbidityconstitutes one of the major challenges in modern medicine.Throughout the course of diabetes nephropathy development, from its debut to the terminal stage, survival rate and quality of life arelower than those of other categories of patients. This indicates crucial role of hyperglycemia in accelerated metabolic degradation typicalof CKD.Renal disease severely narrows the spectrum of available glucose-lowering agents. Concurrent treatment for hypertension and dyslipidemia,as well as anti-platelet therapy and stimulation of erythropoiesis becomes a complex issue. A creative and patient-orientedapproach with clear metabolic and cardiovascular goals should be instrumental in its solution.