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MOLECULAR CHANGES IN PROXIMAL TUBULE FUNCTION IN DIABETES MELLITUS

1. Diabetic kidney disease is initially associated with hypertension and increased urinary albumin excretion. The hypertension is mediated by enhanced volume expansion due to enhanced salt and water retention by the kidney. The increased urinary albumin is not only due to increased glomerular leak, but also to a decrease in albumin reabsorption by the proximal tubule. The precise molecular mechanisms underlying these two phenomena and whether there is any link between the increase in Na+ retention and proteinuria remain unresolved.