Abstract
Wide spectrum of drugs that can be effective in both primary and secondary prevention of diabetic kidney disease is now for clinical use, yet in many cases may not be effective enough or even fail. Antidiabetic agents can affect by the mechanism nondependent on the glycaemic control or direct renoprotective effects.
The question is whether treatment procedures for the choice of antidiabetics depends on the duration of diabetes, the presence of macrovascular complications and the presence and severity of kidney disease. We know that preventing the onset or slowing the progression of diabetic kidney disease also means lowering the risk of cardiovascular complications in patients with diabetes.
Therefore, it is advisable to choose drugs that do not impair renal function. When choosing antidiabetics, it should also be borne in mind that diabetic kidney function is labile compared to people without diabetes.
Acute exacerbations such as illness or various therapeutic interventions should be considered. It is preferable to choose drugs which are not depend on renal function.