Lipoproteins and Diabetic Nephropathy

Diabetic nephropathy has a significant impact on the quality of life and longevity for patients with type 1 or type 2 diabetes. Declining kidney function leads to secondary metabolic effects and adverse changes in lipoprotein metabolism, but, crucially, in patients with diabetes, the lipid abnormalities often emerge before the glomerular reserve is lost. The lipid profile is strongly correlated with albuminuria and predicts adverse outcomes, especially in the presence of other risk factors, such as poor glycemic control, obesity, and hypertension. In this chapter, we discuss the diagnostic and prognostic significance of lipoproteins and their subclasses in diabetic kidney disease and evaluate the evidence from clinical trials of lipid-lowering treatment and renal outcomes.