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Kidney disease in diabetology: lessons from 2008.

Microand macroalbuminuria are important markers for early and progressive diabetic kidney disease. Patients with type 1 diabetes carry a 20–50% risk of developing end-stage renal disease (ESRD) requiring dialysis or renal transplantation. The primary goal of managing childhood type 1 diabetes is to prevent or delay renal and retinal microvascular complications. In contrast to patients with type 2 diabetes, the cumulative incidence of nephropathy has significantly declined in patients with type 1 diabetes over the past three decades, which was due to more intensified treatment regimens for control of hyperglycaemia, hypertension and dyslipidaemia. However, many patients with type 1 diabetes have their manifestation of disease already at very young age, when strict diabetes control is more difficult to reach compared to patients with manifestation of diabetes later in life.