Management of Diabetic Nephropathy in the Elderly: Special Considerations
- *Corresponding Author:
- Alaa S. Awad
Department of Medicine, Division of Nephrology
Penn State Hershey Medical Center
Hershey PA, USA
E-mail: [email protected]
Received Date: June 11, 2011; Accepted Date: July 30, 2012; Published Date: August 03, 2012
Citation: Abdel-Rahman EM, Alhamad T, Brian Reeves W, Awad AS (2012) Management of Diabetic Nephropathy in the Elderly: Special Considerations. J Nephrol Therapeut 2:124. doi:10.4172/2161-0959.1000124
Copyright: © 2012 Abdel-Rahman EM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The incidence and prevalence of End-Stage Renal Disease (ESRD) secondary to Diabetic Nephropathy (DN) have been progressively increasing, reaching pandemic proportions over the past 20 years. Diabetes mellitus is responsible for more than 40% of all cases of ESRD in the United States. Despite that, the treatment of DN is still suboptimal. Both the elderly and diabetic populations are among the fastest growing categories. While several guidelines are available for management of DN in the general population, elderly patients have unique characteristics that may require adaptation of the general therapeutic guidelines used for the general population. Current therapy directed at delaying the progression of DN in elderly includes optimal glycemic and blood pressure control, proteinuria/albuminuria reduction, interruption of the renin-angiotensin-aldosterone system through the use of angiotensin converting enzyme inhibitors and angiotensin type-1 receptor blockers, along with dietary modification and cholesterol lowering agents. This review highlights the available standard therapeutic approaches to manage progressive DN in elderly.