genitourinary disorders
Diabetic Nephropathy
Introduction
Diabetic nephropathy is glomerular sclerosis and fibrosis caused by the metabolic and hemodynamic changes of diabetes mellitus. It manifests as slowly progressive albuminuria with worsening hypertension and renal insufficiency. Diagnosis is based on history, physical examination, urinalysis, and urinealbumin/creatinine ratio. Treatment is strict glucose control, angiotensin inhibition (using angiotensin-converting enzyme [ACE] inhibitors orangiotensin IIreceptor blockers [ARBs]), and control of blood pressure and lipids. (See also Diabetic Nephropathy .) Diabetic nephropathy is the most common cause of Overview of Nephrotic Syndrome in adults. Diabetic nephropathy is also the most common cause of Duration and degree of hyperglycemia Hypertension None Dyslipidemia None Smoking and Other Tobacco Use None Certain polymorphisms affecting the renin-angiotensin-aldosterone axis Family history of diabetic nephropathy Genetic variables (decreased number of glomeruli) Because type 2 diabetes is often present for several years before being recognized, nephropathy often develops<10 years after diabetes is diagnosed. End-stage kidney disease (ESKD) usually takes≥10 years after the onset of nephropathy to develop. 