Diabetic Glomerulopathy: Pathogenesis and Management
Although not all renal disease that diabetic patients develop is due to diabetic glomerulosclerosis, the great majority of patients progressing to advanced renal failure suffer from diffuse or nodular (Kimmelstiel Wilson′s) diabetic glomerulosclerosis. This condition has become the single...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2000-01-01
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| Series: | Saudi Journal of Kidney Diseases and Transplantation |
| Subjects: | |
| Online Access: | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2000;volume=11;issue=3;spage=405;epage=413;aulast=Schmidt |
| _version_ | 1811262591707643904 |
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| author | Schmidt Susanne Ismail Abdullah Ritz Eberhard |
| author_facet | Schmidt Susanne Ismail Abdullah Ritz Eberhard |
| author_sort | Schmidt Susanne |
| collection | DOAJ |
| description | Although not all renal disease that diabetic patients develop is due to diabetic glomerulosclerosis, the great majority of patients progressing to advanced renal failure suffer from diffuse or nodular (Kimmelstiel Wilson′s) diabetic glomerulosclerosis. This condition has become the single most frequent cause of end-stage renal failure in the Western world. Recent studies indicate that an interplay between genetic predisposition and other factors such as hyperglycemia, blood pressure, age, gender, smoking and ethnicity, predispose to nephropathy both in type 1 and type 2 diabetes mellitus. It has also become clear that trace albuminuria ("microalbuminuria") provides a unique opportunity to recognize incipient renal involvement early on, particularly in type 1 and less specifically in type 2 diabetes. Increasing evidence indicates that early intervention delays progression of nephropathy. Factors which promote progression of nephropathy include hypertension, proteinuria, smoking, poor glycemic control and, less certainly, high dietary protein intake and hyperlipidemia. The most important strategies to combat the medical catastrophe of increasing numbers of diabetic patients with end-stage renal failure include (i) prevention of diabetes (mainly type 2), (ii) glycemic control to prevent onset of renal involvement and (iii) meticulous antihypertensive treatment to avoid progression of nephropathy. Survival of diabetic patients on dialysis and after transplantation is inferior to that of non-diabetic patients, mainly because of high rate of cardiovascular death. There is consensus that in the absence of major vascular disease the best treatment is renal transplantation in the type 2 diabetic patient and combined kidney and pancreas transplantation in the type 1 diabetic patient. |
| first_indexed | 2024-04-12T19:28:15Z |
| format | Article |
| id | doaj.art-4036b34cf0144ab3bf884d37f8ddda23 |
| institution | Directory Open Access Journal |
| issn | 1319-2442 |
| language | English |
| last_indexed | 2024-04-12T19:28:15Z |
| publishDate | 2000-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Kidney Diseases and Transplantation |
| spelling | doaj.art-4036b34cf0144ab3bf884d37f8ddda232022-12-22T03:19:24ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422000-01-01113405413Diabetic Glomerulopathy: Pathogenesis and ManagementSchmidt SusanneIsmail AbdullahRitz EberhardAlthough not all renal disease that diabetic patients develop is due to diabetic glomerulosclerosis, the great majority of patients progressing to advanced renal failure suffer from diffuse or nodular (Kimmelstiel Wilson′s) diabetic glomerulosclerosis. This condition has become the single most frequent cause of end-stage renal failure in the Western world. Recent studies indicate that an interplay between genetic predisposition and other factors such as hyperglycemia, blood pressure, age, gender, smoking and ethnicity, predispose to nephropathy both in type 1 and type 2 diabetes mellitus. It has also become clear that trace albuminuria ("microalbuminuria") provides a unique opportunity to recognize incipient renal involvement early on, particularly in type 1 and less specifically in type 2 diabetes. Increasing evidence indicates that early intervention delays progression of nephropathy. Factors which promote progression of nephropathy include hypertension, proteinuria, smoking, poor glycemic control and, less certainly, high dietary protein intake and hyperlipidemia. The most important strategies to combat the medical catastrophe of increasing numbers of diabetic patients with end-stage renal failure include (i) prevention of diabetes (mainly type 2), (ii) glycemic control to prevent onset of renal involvement and (iii) meticulous antihypertensive treatment to avoid progression of nephropathy. Survival of diabetic patients on dialysis and after transplantation is inferior to that of non-diabetic patients, mainly because of high rate of cardiovascular death. There is consensus that in the absence of major vascular disease the best treatment is renal transplantation in the type 2 diabetic patient and combined kidney and pancreas transplantation in the type 1 diabetic patient.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2000;volume=11;issue=3;spage=405;epage=413;aulast=SchmidtDiabetic glomerulopathyProteinuriaMicroalbuminuriaHypertensionGlomerulosclerosis. |
| spellingShingle | Schmidt Susanne Ismail Abdullah Ritz Eberhard Diabetic Glomerulopathy: Pathogenesis and Management Saudi Journal of Kidney Diseases and Transplantation Diabetic glomerulopathy Proteinuria Microalbuminuria Hypertension Glomerulosclerosis. |
| title | Diabetic Glomerulopathy: Pathogenesis and Management |
| title_full | Diabetic Glomerulopathy: Pathogenesis and Management |
| title_fullStr | Diabetic Glomerulopathy: Pathogenesis and Management |
| title_full_unstemmed | Diabetic Glomerulopathy: Pathogenesis and Management |
| title_short | Diabetic Glomerulopathy: Pathogenesis and Management |
| title_sort | diabetic glomerulopathy pathogenesis and management |
| topic | Diabetic glomerulopathy Proteinuria Microalbuminuria Hypertension Glomerulosclerosis. |
| url | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2000;volume=11;issue=3;spage=405;epage=413;aulast=Schmidt |
| work_keys_str_mv | AT schmidtsusanne diabeticglomerulopathypathogenesisandmanagement AT ismailabdullah diabeticglomerulopathypathogenesisandmanagement AT ritzeberhard diabeticglomerulopathypathogenesisandmanagement |