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Diabetic Nephropathy
Alternate Names : Diabetic Glomerulosclerosis, Diabetic Kidney Disease, Kimmelstiel-Wilson Disease
DefinitionDiabetic nephropathy is a complication of diabetes. If you have this condition, your kidney loses its ability to function properly. The condition is characterized by high protein levels in the urine.
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Overview, Causes, & Risk Factors
Each kidney is made of more than a million units called nephrons. Each nephron has a tuft of blood vessels called a glomerulus. The glomerulus filters blood and forms urine, which drains down into collecting ducts to the ureter.
The earliest detectable change in the course of diabetic nephropathy is a thickening in the glomerulus. At this stage, the kidney may start allowing more albumin (protein) than normal in the urine, and this can be detected by sensitive tests for albumin. This stage is called "microabuminuria" (micro refers to the small amounts of albumin).
As diabetic nephropathy progresses, increasing numbers of glomeruli are destroyed. Now the amounts of albumin being excreted in the urine increases, and may be detected by ordinary urinalysis techniques. At this stage, a kidney biopsy clearly shows diabetic nephropathy.
Protein may appear in the urine for 5 to 10 years before other symptoms develop. High blood pressure often accompanies diabetic nephropathy. Over time, the kidney's ability to function starts to decline. Diabetic nephropathy may eventually lead to chronic kidney failure. The disorder continues to progress toward end-stage kidney disease, usually within 2 to 6 years after the appearance of high protein in the urine (proteinuria).
Diabetic nephropathy is the most common cause of chronic kidney failure and end-stage kidney disease in the United States. People with both type 1 and type 2 diabetes are at risk. The risk is higher if blood-glucose levels are poorly controlled. However, once nephropathy develops, the greatest rate of progression is seen in patients with poor control of their blood pressure.
Diabetic nephropathy is generally accompanied by other diabetes complications including hypertension, retinopathy, and vascular (blood vessel) changes, although these may not be obvious during the early stages of nephropathy. Nephropathy may be present for many years before high protein in the urine or chronic kidney failure develop.
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Definition Overview, Causes, & Risk Factors Symptoms & Signs Prevention Diagnosis & Tests Treatment Prognosis Complications Calling Your Health Care Provider
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Topics that might be of interest to you Diseases & Conditions
Chronic Renal Failure Diabetes Diabetic Retinopathy End-Stage Kidney Disease Hyperkalemia Hypertension Hypoglycemia Peritonitis Retinopathy of Prematurity
Tests & Exams
BUN Creatinine - Serum Creatinine - Urine Dialysis Glucose Test Microalbuminuria Test Protein - Urine Protein Electrophoresis - Urine Renal Biopsy Urinalysis
Surgery & Procedures
Kidney Transplant
Other Topics
Appetite - Decreased Diabetes - Diet Fatigue Foot, Leg, and Ankle Swelling Headache Hiccups Malaise Nausea and Vomiting Urine Output - Decreased
Review Date : 11/1/2003
Reviewed By : Irfan A. Agha, M.D., Department of Medicine, Renal Division, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.
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