Diabetes mellitus – a leading risk factor for the development and progression of chronic kidney disease

Abstract

Chronic kidney disease (CKD) and diabetes mellitus (DM) are major noncommunicable diseases worldwide and represent interconnected and growing public health challenges. Diabetes is a leading risk factor for the development and progression of CKD, with up to 40% of patients with type 2 diabetes developing diabetic kidney disease. The increasing global burden of diabetes – including the increase observed following the COVID-19 pandemic – highlights the need for early prevention, screening, and integrated models of care. Epidemiological trends show a steady increase in the prevalence of CKD, with projections indicating that by 2040 CKD will be among the leading causes of mortality worldwide. Diabetic kidney disease develops through metabolic, vascular, and inflammatory mechanisms. Multiple modifiable and nonmodifiable risk factors accelerate kidney damage, highlighting the importance of early identification and prevention. Current therapeutic strategies focus on tight glycemic control, optimal blood pressure management, screening for albuminuria and eGFR, and the use of renoprotective medications such as ACE inhibitors/ARBs, SGLT2 inhibitors, and GLP-1 receptor agonists. Individualized dietary interventions and physical activity are essential components of comprehensive care. Pharmacists play a key role in therapeutic monitoring, medication optimization, patient education, and adherence support. In many countries, pharmacists are involved in the early detection of CKD through point-of-care testing (POCT) in pharmacies, facilitating early referral and intervention. This review highlights the importance of a multidisciplinary, proactive, and prevention-oriented approach aimed at slowing the progression of CKD and improving patient outcomes.