[Diabetes and the kidneys].

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease and requires renal replacement therapy. Regular screening for microalbuminuria is indispensable for early diagnosis. To prevent or at least delay the onset of DN and progressive renal failure in type 1 and type 2 diabetics, glucose control, blood pressure control and, in particular, the blocking of the renin-angiotensin system are the most effective renoprotective measures. Other factors influencing the course of DN are cigarette smoking and hyperlipidaemia. The latest trials have been reviewed and a treatment involving the cooperation of general practitioners, nephrologists and diabetologists has been suggested.