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Diabetic kidney disease
Reviewed by Professor Ian W Campbell, consultant physician, adult diabetes and Dr Soon Song, consultant physician
Angiotensin II receptor blockers
These drugs work in a different way to ACE inhibitors, but are also used to control blood pressure. Their main advantage is their low tendency to cause side effects – in particular they do not cause coughing.
Like ACE inhibitors, angiotensin II receptor blockers have also been shown to be beneficial in diabetic kidney disease.
One study looked at people with Type 2 diabetes and microalbuminuria over two years. It found the number who went on to develop high levels of protein in urine (proteinuria) was reduced by two thirds, regardless of their blood pressure level.
In the long term
If microalbuminuria is detected at an early stage, treatment can begin and the risk of aggravating kidney disease is lowered.
Good care of diabetes and risk factors such as high blood pressure means only a small number of people with diabetes experience the gradual decrease of kidney function that ends with dialysis and possible kidney transplant.
Kidney transplant
People with diabetes can receive a kidney transplant as successfully as any other person.
In some centres a transplant of the pancreas is done at the same time as the kidney transplant - removing the need for insulin or tablet treatment for diabetes.
A kidney transplant is the only way for someone with severe kidney failure to receive long-term treatment that doesn't depend on machines or dialysis.
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