Clinical manifestations and natural history of diabetic kidney disease.

Renal failure in type 2 diabetes has been termed "a medical catastrophe of worldwide dimension". In 2001, we found in our unit that 49% of incident patients requiring maintenance hemodialysis had diabetes (i.e. 98/million population/year), 6% of whom had type 1 and most (94%) had type 2 diabetes, i.e. more than the than reported frequency in Germany (approximately 35% of incident patients). The frequency is underestimated because hyperglycemia is often lost in the preterminal phase when diabetic patients lose weight and fasting hyperglycemia. Copyright © 2013 Elsevier Inc. All rights reserved.