ABSTRACT
Accurate assessment of kidney function is fundamental for determining the prevalence and progression of kidney impairment, for morbidity and mortality risk stratification associated with chronic kidney disease, and for evaluating the impact of new therapies in elderly populations. While a rise in serum creatinine nearly always represents a loss in function, the elderly patient may have significant kidney impairment despite a normal serum creatinine level, due to variations in creatinine metabolism. The hallmark of therapy for diabetic nephropathy is the triad of blood glucose control, blood pressure (BP) control, and administration of angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin-receptor blockers. The importance of BP control in slowing the progression of diabetic kidney disease has been established in many studies. A principal goal of blood sugar control, BP control, and the administration of ACE-Is and angiotensin-receptor blockers is reduction of proteinuria.
