When diabetic nephropathy develops in the context of both type 2 diabetes mellitus and chronic kidney disease, standard glycaemic management alone is insufficient — the treatment approach must also directly address kidney protection.
This protocol applies to patients with type 2 diabetes mellitus who have concurrent chronic kidney disease (CKD). Both conditions together define the specific treatment pathway, since CKD alters pharmacological eligibility and makes renal outcome endpoints a central therapeutic priority.
Evidence supports the use of a specific class of kidney-protective agents with demonstrated benefit in reducing renal outcomes in clinical trials; the full regimen — including eligible agents, continuation criteria, and the individualised glycaemic target of HbA1c < 7% — is contained in the structured protocol.
DOI: 10.1016/j.nefro.2024.11.002