Diabetic nephropathy is one of the microvascular complications of diabetes. Its incidence is decreasing in insulin dependent patients, but extremely increasing in non-insulin dependent patients in developed countries. The development of nephropathy in an individual patient cannot be predicted in spite of new information about genetics and pathophysiology of the disease. Clinical course progresses from microalbuminuria to overt proteinuria and than to renal failure. The disease cannot be cured, but can be prevented or limited in progression. The most important measures are maintaining of normoglycaemia and blood pressure in low-normal values (best using ACE inhibitors), treatment of hypercholesterolaemia and protein restriction. Renal replacement therapy is available for all diabetic patients in our country without restriction, the best method is kidney transplantation if not contraindicated.

1 interní klinika 1 LF UK a VFN Praha