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Q J Med 2000; 93: 643-646
© 2000 Association of Physicians

Editorial

Diabetic nephropathy—where next?

A.O. Phillips

Institute of Nephrology, University of Wales College of Medicine, Cardiff

Diabetic nephropathy (DN) is a common complication of diabetes mellitus which has a major impact on patient morbidity and mortality and therefore a profound impact on the delivery of health care in this country. It affects more than one third of patients with insulin-dependent diabetes mellitus (type 1 diabetes),1 and up to a quarter of all patients with non-insulin-dependent diabetes mellitus (type 2 diabetes).2 It is therefore the single most common cause of end-stage renal failure (ESRF) in Western countries. There is a consensus that survival and rehabilitation of diabetic patients on renal replacement programs continues to be inferior to that of non-diabetic patients, although survival has greatly improved since the report of Ghavanmian et al.3 which concluded ‘... there is little prospect of improving the quality of life for patients with diabetic nephropathy and renal failure, and that survival is likely to be short. For some, we only . . . [Full Text of this Article]

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