Chronic kidney disease in patients with diabetes mellitus: new challenges

Chronic kidney disease (CKD) is a supranosological concept, defined as a disorder of the structure and/or function of the kidneys for 3 months or more that leads to health consequences. CKD develops in 20–40% of patients with diabetes mellitus (DM). Dynamic analysis of epidemiological indicators of CKD in patients with diabetes mellitus points to the prevalence increase of this pathology in the Russian Federation in 2010–2022. Improved quality of diagnostics of earlier stages complications, a decrease in the risk of cardiovascular events (the leading cause of death) and end-stage renal failure at a later age and with a longer duration of diabetes are noted as well. The development of tools for predicting the risk of the pathology progression and its complications has made it possible to improve patient monitoring and routing. Current international and domestic recommendations emphasize a comprehensive approach to the treatment of CKD, including lifestyle modification, evidence-based pharmacological treatments aimed at preserving organ function, and improving cardiovascular prognosis. An optimal model of care for patients with diabetes and CKD, aimed at multidisciplinary care and adapted according to the severity of CKD, will lead to the best outcomes for the individual patient and society.