Chapter II. Diabetic Nephropathy

Diabetic Nephropathy: New Risk Factors and Improvements in Diagnosis

Konstantinos Tziomalos¹, Vasilios G. Athyros²

Manuscript submitted April 10, 2015; resubmitted April 30, 2015; accepted April 30, 2015.

Keywords: diabetic nephropathy, albuminuria, glomerular filtration rate, diagnosis, risk factors, diabetes

Abstract

Diabetic nephropathy is the leading cause of end-stage renal disease. Patients with diabetic nephropathy have a high cardiovascular risk, comparable to patients with coronary heart disease. Accordingly, identification and management of risk factors for diabetic nephropathy as well as timely diagnosis and prompt management of the condition are of paramount importance for effective treatment. A variety of risk factors promotes the development and progression of diabetic nephropathy, including elevated glucose levels, long duration of diabetes, high blood pressure, obesity, and dyslipidemia. Most of these risk factors are modifiable by antidiabetic, antihypertensive, or lipid-lowering treatment and lifestyle changes. Others such as genetic factors or advanced age cannot be modified. Therefore, the rigorous management of the modifiable risk factors is essential for preventing and delaying the decline in renal function. Early diagnosis of diabetic nephropathy is another essential component in the management of diabetes and its complications such as nephropathy. New markers may allow earlier diagnosis of this common and serious complication, but further studies are needed to clarify their additive predictive value, and to define their cost-benefit ratio. This article reviews the most important risk factors in the development and progression of diabetic nephropathy and summarizes recent developments in the diagnosis of this disease.

Fulltext: HTML , PDF (145KB)

This article has been cited by other articles:

	Phyllanthus niruri leaves aqueous extract improves kidney functions, ameliorates kidney oxidative stress, inflammation, fibrosis and apoptosis and enhances kidney cell proliferation in adult male rats with diabetes mellitus Giribabu N, Karim K, Kilari EK, Salleh N J Ethnopharmacol 2017. 205:123-137
	The beneficial effects of zinc on diabetes-induced kidney damage in murine rodent model of type 1 diabetes mellitus Yang F, Li B, Dong X, Cui W, Luo P J Trace Elem Med Biol 2017. 42:1-10
	Clinical efficacy and safety of tripterygium glycosides in treatment of stage IV diabetic nephropathy: A meta-analysis Hong Y, Gui Z, Cai X, Lan L Open Med (Wars) 2016. 11(1):611-617
	Maternal Obesity Promotes Diabetic Nephropathy in Rodent Offspring Glastras SJ, Tsang M, Teh R, Chen H, McGrath RT, Zaky AA, Pollock CA, Saad S Sci Rep 2016. 6:27769