Diabetes is one of the most common causes of chronic kidney disease (CKD). Anemia is a frequent complication of CKD. This article reviews the treatment of anemia in patients with CKD. Topics include the prevalence of anemia in this population, causes and impact of anemia in these patients, target hemoglobin goals, treatment and monitoring, and causes of hyporesponse to anemia treatment.

Secondary hyperparathyroidism (SHPT) describes a complex alteration in bone and mineral metabolism that occurs as a direct result of chronic kidney disease (CKD). Bone disease, a well-recognized complication of SHPT, represents only a small concern in light of the evidence that correlates SHPT with cardiovascular disease and an increased risk of morbidity and mortality in patients with CKD. Patients with mild CKD may be asymptomatic and therefore may not be identified until the pathology of SHPT has begun. Identifying patients at risk and evaluating for SHPT is imperative because early intervention may slow or arrest the progression of both bone and cardiac disease. Dietary concerns, pharmacotherapy, and patient adherence are all important considerations in creating a successful treatment plan.

People with diabetes strive to keep blood glucose, blood pressure, and blood lipids within desirable ranges to prevent long-term complications such as chronic kidney disease. Once that complication has occurred, however, nutritional management becomes even more complex. The National Kidney Foundation has addressed "diabetic kidney disease" in recent guidelines. This article summarizes some of the nutritional strategies to prevent or delay progression to kidney failure.

Diabetes is associated with markedly increased cardiovascular risk, a risk compounded with imposition of chronic kidney disease (CKD). More than 80% of people with diabetes and CKD have hypertension, and many have an obliterated nocturnal blood pressure "dip," the normal physiological drop in blood pressure during sleep. Appropriate blood pressure measurement is the Achilles heel of hypertension management, especially in diabetic kidney disease (DKD). This review elaborates on the evidence regarding one of the most important therapeutic targets in DKD, namely, control of blood pressure to < 130/80 mmHg, and provides detailed information about appropriate blood pressure measurement and treatments to best achieve that target.