International Journal of Diabetes and Endocrinology Diabetic Nephropathy: A Comprehensive Review for Health Care Professionals Research Article Sumon Rahman Chowdhury* 1 , Tasnuva Tanzil 2 , Rezaul Haider Chowdhury 3 , Alam Mohammad Sharif 4 1 Senior Medical Officer, Department of Diabetes, Endocrinology and Metabolism, Chittagong Diabetic General Hospital, Chittagong 2 Assistant Registrar, Department of Anaesthesia and Intensive Care Unit, Chattogram Medical College Hospital 3 Consultant Internist, Department of Internal Medicine, Chittagong Diabetic General Hospital 4 Consultant, Department of Physical Medicine, Chittagong Diabetic General Hospital Corresponding author: Sumon Rahman Chowdhury, Senior Medical Officer, Department of Diabetes, Endocrinology and Metabolism, Chittagong Diabetic General Hospital, Chittagong. Tel: 01670393031; E-mail: sumonrahman79@yahoo.com Citation: Chowdhury SR, Tanzil T, Chowdhury RH, Sharif AM (2020) Diabetic Nephropathy: A Comprehensive Review for Health Care Professionals. Int Jou Diab&Endocrinol: IJDE-108. DOI: 10.46715/ijde2020.11.1000108 Received Date: 12 November, 2020; Accepted Date: 16 November, 2020; Published Date: 23 November, 2020 Keywords: Diabetic Nephropathy, Diabetes, Health Care Professionals Introduction Diabetic Nephropathy (DN) is the leading cause of ESRD in the UK. In 2012, DN accounted for 26% of cases ESRD [1], and 40% diabetics will develop DN [2]. The features of DN are increasing urinary albumin excretion, rising BP and declining renal function [3]. There are specific pathological changes with five different stages. The key is the level of urinary albumin excretion-microalbuminuria (incipient nephropathy) or macroalbuminuria/proteinuria (overt nephropathy) [4]. As it is an asymptomatic process screening is required [2, 3]. Normal Microalbuminuria Macroalbuminuria ACR- Albumin/Creatinine Ratio (mg/mmol) <3.5 female <2.5 male 3.5-30 female >30 24hr collection mg/24hr <30 30-300 >300 Table 1: Levels of UAE (adapted from Holt [5]) In UKPDS, 2% of T2DM with normal UAE progressed to microalbuminuria annually, 2.8% progressed from microalbuminuria to macroalbuminuria (4). At diagnosis 10% will have DN, and 25% in 10 years post diagnosis [4, 6]. Int Jou Diab&Endocrinol: IJDE-108 1 Abstract The prevalence of Chronic Kidney Disease (CKD) continues to escalate at an alarming rate and diabetes has become the most common single cause of End-Stage Renal Disease (ESRD) in the world. This is because diabetes, particularly type 2, is increasing in prevalence, and the patients are living longer now. Diabetes is the major cause of end-stage renal disease in the developed world, accounting for 40% to 50% of cases. Diabetic nephropathy contributes significantly to the economic burden of diabetes. In UK, the cost of diabetic complications in 2011/2012 was estimated at £14 billion, by 2035/2036 this is expected to rise to £22 billion. Worldwide, healthcare costs for diabetic patients are much higher than non- diabetic patients. Also, among diabetic patients the cost of health care is much higher in those with complications (Micro < Macro<Micro + Macrovascular complications) than in those without complications, therefore identifying and controlling diabetes and its complications is essential in reducing the burden of the disease. In this review we shall explore the pathophysiology, risk factors, staging, screening, management and prognosis of Diabetic Nephropathy in explicit details to make it easily understandable for the Health Care Professionals. DOI: 10.46715/ijde2020.11.1000108