Review
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World J Diabetes. Dec 15, 2014; 5(6): 835-846
Published online Dec 15, 2014. doi: 10.4239/wjd.v5.i6.835
Risks of rapid decline renal function in patients with type 2 diabetes
Yi-Jing Sheen, Wayne HH Sheu
Yi-Jing Sheen, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung 403, Taiwan
Wayne HH Sheu, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
Wayne HH Sheu, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
Wayne HH Sheu, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
Wayne HH Sheu, Institute of Medical Technology, National Chung-Hsing University, Taichung 402, Taiwan
Author contributions: Sheen YJ drafted the manuscript; Sheu WHH drafted the manuscript and critically revised it for important intellectual content, and approved the final version of the manuscript to be published.
Correspondence to: Wayne HH Sheu, MD, PhD, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, No.1650, Sec. 4, Taiwan Boulevard, Taichung 407, Taiwan. whhsheu@vghtc.gov.tw
Telephone: +886-4-23741300 Fax: +886-4-23741318
Received: July 2, 2014
Revised: July 26, 2014
Accepted: September 17, 2014
Published online: December 15, 2014
Processing time: 164 Days and 17 Hours
Core Tip

Core tip: The progression rate of diabetic kidney disease is highly variable, a rapid decline of renal function can lead to renal failure within months. Risk factors account for rapid decline renal function in patients with type 2 diabetes include ethnic/genetic and demographic factors, lifestyle and health behaviors, advanced albuminuria, poor glycemic control, dyslipidemia and some biochemical abnormalities. Diabetic patients with retinopathy or cardiac autonomic neuropathy are at increased risk of a rapid decline in estimated glomerular filtration rate. Early detection of high-risk groups with a more aggressive multifactorial approach to renal and cardiovascular protection is important.