A GP guide to chronic kidney disease in diabetes

'Unusual' features should alert the clinician to potential alternative coexisting pathologies.

Diabetes is the most common cause of kidney failure (37% non-Indigenous Australians; 69% Indigenous Australians) and around 50% of people with type 2 diabetes (T2DM) will develop diabetic nephropathy.1,2

The natural history is initial hyperfiltration before the onset of albuminuria which progresses to overt proteinuria after which the eGFR declines.

In the setting of type 1 diabetes (T1DM) this develops over the course of 20-plus years.

However, the subclinical nature of T2DM means that complications such as nephropathy may be present at the time of diagnosis.