Anaemia in diabetic kidney disease: An area for improvement?

Kidney disease associated with diabetes is the most common cause of kidney failure. The development of kidney disease in diabetes can be associated with a dramatic increase in the risk of cardiovascular morbidity and mortality and with a significant effect on quality of life. The focus of recent guidelines has been on the detection of kidney disease and treatment of the main drivers, namely glycaemic control and blood pressure. Only recently has the impact of anaemia in the diabetes population come to the fore. We now know that anaemia is more frequent in diabetic kidney disease and occurs at an earlier stage often when kidney function is only moderately impaired. Much of this anaemia is undiagnosed, yet effective treatment is available and improves quality of life, reduces symptoms and may have major beneficial effects on cardiovascular morbidity and mortality. There is a need for heightened recognition of the importance of anaemia, guidelines on screening and management, and research into optimum treatment and what benefits might accrue.