Table 2—

Strategies and goals for reno- and cardioprotection in patients with diabetic nephropathy

InterventionGoal
MicroalbuminuricMacroalbuminuric
ACE inhibitor and/or ARB and low-protein diet (0.6–0.8 g · kg wt−1 · day−1Reduction of albuminuria or reversion to normoalbuminuriaProteinuria as low as possible or <0.5 g/24-h and
GFR stabilizationGFR decline <2 ml · min−1 · year−1
Antihypertensive agentsBlood pressure <130/80 or 125/75 mmHg
Strict glycemic controlA1c <7%
StatinsLDL cholesterol ≤100 mg/dl
Acetyl salicylic acidThrombosis prevention
Smoking cessationPrevention of atherosclerosis progression
  • * Low-protein diet: efficacy not proven in long-term studies in microalbuminuric patients.

  • Goal: 125/75 mmHg with increased serum creatinine and proteinuria >1.0 g/24-h.

  • LDL cholesterol <70 mg/dl in the presence of cardiovascular disease.