Terézia Pázmanová, Peter Ponťuch
Diabetic nephropathy is the leading cause of endstage renal disease in Europe and USA and is associated with increased cardiovascular mortality. Microalbuminuria is the first clinical manifestation of diabetic nephropathy, it is also the predictor of cardiovascular morbidity and mortality of diabetes patients. Hyperglycemia, increased blood pressure levels are the main risk factors for development of diabetic nephropathy. Elevated serum lipids, smoking habits, the amount and origin of dietary protein also seem to play a role as risk factors. Achieving the best glycemic control (HbA1c < 7 %), treating hypertension (< 130/80 mmHg, or < 125/75 mmHg if proteinuria > 1g/24 h and increased serum creatinine) using agents that block reninangiotensin- aldosteron system and treating dyslipidemia (LDL cholesterol < 2,6 mmol/l) are effective strategies for preventing the development of microalbuminuria, in retarding the progression to more advanced stages of diabetic nephropathy.