Non-proteinuric diabetic kidney disease: State of art

Abstract

Diabetic kidney disease (DKD) is one of the chronic complications with the highest incidence of diabetes mellitus and is a public health problem today. Classically, five stages defined by Mogensen in 1980 have been described, where the presence of albuminuria stands out as an early marker of renal compromise. However, 20-30% of patients with DKD have been documented in recent years who do not present with proteinuria despite having a compromised glomerular filtration rate. This group has been called non-albuminuric phenotype ERD. Several atypical phenotypes have been described, the non-albuminuric phenotype being one of the most frequent in this group. Next, we review the non-albuminuric phenotype of diabetic kidney disease, from its pathophysiology to therapeutic measures that impact mortality and progression to end-stage kidney disease.