TABLE 9.

Management of CKD in Diabetes

GFR (mL/min/1.73 m2)	Recommended management
All patients	Yearly measurement of creatinine, UACR, potassium
45–60	Referral to a nephrologist if possibility for nondiabetic kidney disease exists (duration of type 1 diabetes <10 years, persistent albuminuria, abnormal findings on renal ultrasound, resistant hypertension, rapid fall in eGFR, or active urinary sediment on urine microscopic examination)
	Consider the need for dose adjustment of medications
	Monitor eGFR every 6 months
	Monitor electrolytes, bicarbonate, hemoglobin, calcium, phosphorus, and parathyroid hormone at least yearly
	Assure vitamin D sufficiency
	Consider bone density testing
	Referral for dietary counseling
30–44	Monitor eGFR every 3 months
	Monitor electrolytes, bicarbonate, calcium, phosphorus, parathyroid hormone, hemoglobin, albumin, and weight every 3–6 months
	Consider the need for dose adjustment of medications
<30	Referral to a nephrologist