ABSTRACT
INTRODUCTION Advanced renal involvement in the diabetic patient may be defined as a major decrease in glomerular filtration rate (GFR) to below 30 ml/min and/or urinary excretion of protein within the nephrotic range (>3. 5 g/day). At this stage, there is inexorable progression of renal disease, and the patient will reach end-stage renal disease (ESRD) within a relatively short period (months to a few years). Treatment of these patients should be aimed at reducing the progression of the renal disease, at preventing or treating comorbid conditions, and at preparing the patient for renal replacement therapy (RRT).
