Non-albuminuric Diabetic Kidney Disease in Diabetic Patients: A Review

Introduction: The constantly increasing incidence of type 2 diabetes, probably due to obesity and sedentary life, has led to the increased incidence of macro- and microvascular diabetic complications such as nephropathy. Despite the prompt efforts to develop effective treatments for diabetes and slow the progression of its complications, it is still reported as the most common cause of chronic kidney disease in developed countries. Albuminuria has been widely accepted as the first sign of diabetic nephropathy and an independent factor for acute kidney failure. However, growing evidence suggests diminished kidney function and decreased glomerular filtration rate (GFR)in a significant number of non-albuminuric patients with type 1 or type 2 diabetes, known as non-albuminuric diabetic kidney disease (NA-DKD). This highlights the need for more research on reduced kidney function in non-albuminuric diabetic patients. The present study examined the known epidemiology, pathology, kidney prognosis, and mortality rate from NA-DKD compared to various types of albuminuria. The study also characterized the potential mechanisms of NA-DKD and discussed its future perspective.