Strengthening the understanding of normoalbuminuric diabetic kidney disease

Diabetic kidney disease (DKD) is a primary cause for end-stage renal disease (ESRD). Early diagnosis is very important for preventing the progression of DKD. Assessment of urinary albumin excretion rate (UAER) played a key role in the diagnosis and clinical stages of patients with DKD. Actually, many diabetic mellitus (DM) patients sometimes showed nonalbuminuric renal insufficiency, which was named normoalbuminuric diabetic kidney disease (NADKD), nonalbuminuric diabetic nephropathy, or nonalbuminuric renal impairment in diabetes. In this article, the authors discussed NADKD in epidemiology, pathology, clinical features, diagnosis and treatment, etc, hoping to attract attention from colleagues in nephrology. Key words: Diabetes; Diabetic kidney disease; Normoalbuminuria; Renal insufficiency