Diabetic Kidney Disease in Type 2 Diabetes: A Comprehensive Review of Epidemiology, Pathophysiology, and Therapeutic Advances

Chronic kidney disease (CKD) is a major complication of type 2 diabetes mellitus ( T2DM ), affecting 20%–50% of patients and leading to end-stage kidney disease (ESKD). This review synthesizes literature on CKD in T2DM , focusing on the epidemiology, pathophysiology, and management strategies, including oral hypo-glycemic agents and emerging therapies. A systematic search across PubMed, Scopus, and Web of Science prioritized studies from 2010 to 2025. Findings high-light the multifactorial pathogenesis of diabetic kidney disease (DKD), driven by hyperglycemia, hypertension, and oxidative stress. Sodium-glucose cotransporter-2 ( SGLT2 ) inhibitors and glucagon-like peptide-1 receptor agonists ( GLP-1 RAs ), show nephroprotective effects, while biomarkers like estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR) enable early detection. Precision medicine holds promise for personalized treatment, but gaps in clinical practice and patient adherence persist, necessitating multidisciplinary approaches.