Reducing the risk of cardiovascular disease in patients with diabetic kidney disease

The presence of diabetic kidney disease significantly increases the risk of cardiovascular disease in both type 1 and type 2 diabetes. Consider using statin treatment to reduce cardiovascular risk, irrespective of the cardiovascular risk score, for adults with diabetes and:

• microalbuminuria (more than 20 micrograms/min, or urinary albumin-to-creatinine ratio more than 2.5 mg/mmol for men or more than 3.5 mg/mmol for women)
• moderate or severe chronic kidney disease (persistent proteinuria or eGFR less than 45 mL/min/1.73 m²).

For adults with stage 5 chronic kidney disease on dialysis, the benefits of statin treatment are less clear.

For patients with type 2 diabetes, consider the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors; these drugs significantly reduce the risk of death from cardiovascular or renal causes in patients with chronic kidney disease.

For advice on using statin therapy to reduce cardiovascular risk, see Lipid modification.

For general information on cardiovascular disease in patients with diabetes, see here.