Management of Hyperglycemia in Diabetic Kidney Disease / 임상당뇨병

ABSTRACT

Diabetes has reached epidemic proportions in Korea and worldwide, and is associated with increased risk for chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Given the increasing prevalence of diabetes and its high morbidity and mortality, diabetic kidney disease (DKD) represents a serious concern in individual patients and a considerable socioeconomic burden. The kidneys contribute to glucose homeostasis through processes of gluconeogenesis, glucose filtration, glucose reabsorption, and glucose consumption. Decreased nephron mass and kidney dysfunction due to DKD progression lead to the complicated state that causes both hypoglycemia and hyperglycemia. Appropriate management tailored for DKD patients is required to improve their morbidity and mortality. This review focuses on special issues related to the management of DKD, including clinical kidney outcomes in DKD progression, glycemic control indices and targets for diabetes mellitus (DM) CKD, glucose management of advanced DM CKD or ESKD and tailored medications for DKD based on clinical evidence.