diabetic nephropathy


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Related to diabetic nephropathy: diabetic retinopathy, diabetic neuropathy

nephropathy

 [nĕ-frop´ah-the]
1. any disease of the kidneys. adj., adj nephropath´ic.
2. any disease of the kidneys; see also nephritis. Called also nephrosis. adj., adj nephropath´ic.
AIDS nephropathy former name for HIV-associated nephropathy.
analgesic nephropathy interstitial nephritis with renal papillary necrosis, seen in patients with a history of abuse of analgesics such as aspirin or acetaminophen alone or in combination.
diabetic nephropathy the nephropathy that commonly accompanies later stages of diabetes mellitus; it begins with hyperfiltration, renal hypertrophy, microalbuminuria, and hypertension; in time proteinuria develops, with other signs of decreasing function leading to end-stage renal disease.
gouty nephropathy any of a group of chronic kidney diseases associated with the abnormal production and excretion of uric acid.
heavy metal nephropathy the kidney damage resulting from any of various forms of heavy metal poisoning, usually in the form of tubulointerstitial nephritis. The most common metals involved are cadmium, lead, and mercury.
HIV-associated nephropathy renal pathology in patients infected with the human immunodeficiency virus, similar to focal segmental glomerulosclerosis, with proteinuria, enlarged kidneys, and dilated tubules containing proteinaceous casts; it may progress to end-stage renal disease within weeks.
hypokalemic nephropathy nephropathy with hypokalemia, interstitial nephritis, swelling and vacuolization of proximal renal tubules, and progressive renal failure, resulting from conditions such as oncotic overloading of the kidney filtration mechanisms by sugars. See also potassium-losing nephropathy.
IgA nephropathy a chronic form marked by hematuria and proteinuria and by deposits of IgA immunoglobulin in the mesangial areas of the renal glomeruli, with subsequent reactive hyperplasia of mesangial cells. Called also Berger's disease and IgA glomerulonephritis.
ischemic nephropathy nephropathy resulting from partial or complete obstruction of a renal artery with ischemia, accompanied by a significant reduction in the glomerular filtration rate.
lead nephropathy the kidney damage that accompanies lead poisoning; lead deposits appear in the epithelium of the proximal tubules and as nuclear inclusions in cells. In time this leads to tubulointerstitial nephritis with chronic renal failure and other symptoms.
membranous nephropathy membranous glomerulonephritis.
minimal change nephropathy minimal change disease.
obstructive nephropathy nephropathy caused by obstruction of the urinary tract (usually the ureter), with hydronephrosis, slowing of the glomerular filtration rate, and tubular abnormalities.
potassium-losing nephropathy hypokalemic nephropathy after persistent potassium loss; it may be seen in metabolic alkalosis, adrenocortical hormone excess, or in intrinsic renal disease such as renal tubular acidosis or hyperplasia of juxtaglomerular cells. Called also potassium-losing nephritis.
reflux nephropathy childhood pyelonephritis in which the renal scarring results from vesicoureteric reflux, with radiological appearance of intrarenal reflux.
salt-losing nephropathy intrinsic renal disease causing abnormal urinary sodium loss in persons ingesting normal amounts of sodium chloride, with vomiting, dehydration, and vascular collapse. Called also salt-losing nephritis.
urate nephropathy (uric acid nephropathy) any of a group of kidney diseases occurring in patients with hyperuricemia, including an acute form, a chronic form (gouty nephropathy), and nephrolithiasis with formation of uric acid calculi.

diabetic nephropathy

a syndrome characterized by albuminuria, hypertension, and progressive renal insufficiency.

Diabetic nephropathy is a major cause of morbidity and mortality in people with diabetes mellitus (DM). Patients with DM make up the largest number (50%) of those who start renal dialysis for end-stage renal disease (ESRD) each year in the U.S. The prevalence of ESRD approaches 50% among people who have had Type 1 DM for 20 years. The risk of diabetic nephropathy is higher in males, blacks, Hispanics, and Native Americans. Within 3 years after the diagnosis of DM is made, histologic study shows thickening of glomerular basement membrane, capsular drop deposits, and mesangial proliferation, changes characteristic of diabetic glomerulosclerosis (Kimmelstiel-Wilson disease). The kidneys increase in size and weight because of both hypertrophy and hyperplasia of parenchymal cells, and renal blood flow and glomerular filtration rate (GFR) are increased; as a result, serum creatinine and urea nitrogen levels are slightly reduced. After 10-15 years, the first evidence of renal damage may appear as microalbuminuria, a persistent excretion of albumin in concentrations not detected by routine tests for urinary protein. An albumin excretion rate of 20-200 mcg/min (30-300 mg/day) heralds the onset of diabetic nephropathy and strongly predicts eventual ESRD. Further progression of renal damage leads to frank albuminuria and a decline in glomerular filtration rate and nitrogen clearance. The prevalence of hypertension is markedly greater in people with microalbuminuria, and hypertension accelerates the progression of renal disease. Diabetic nephropathy can lead to hyperkalemia, metabolic acidosis, nephrotic syndrome, papillary necrosis, and increased susceptibility to acute renal failure after exposure to radiographic contrast media. The onset of microalbuminuria indicates increased risk of cardiovascular disease; myocardial infarction and stroke are statistically more likely to cause death than renal disease in people with microalbuminuria. Current practice guidelines for the treatment of DM call for annual assessment of 24-hour albumin excretion, prompt treatment of urinary tract infections, and avoidance of nephrotoxic drugs (including nonsteroidal antiinflammatory drugs and COX-2 inhibitors) and radiographic dyes. No interventions have been shown to reverse clinical diabetic nephropathy. However, prospective randomized studies have established that improved metabolic control, maintaining plasma glucose as near normal as possible at all times, can markedly retard the development and progression of diabetic nephropathy, as well as of other long-term microvascular complications of diabetes (retinopathy and neuropathy). In addition, aggressive management of hypertension with ACE inhibitors or angiotensin II receptor blockers has been shown to delay progression of nephropathy by mechanisms independent of blood pressure control, and limitation of daily protein intake to 0.8 g/kg of body weight (not appropriate in pregnancy) has been shown to delay progression of both diabetic and nondiabetic renal disease. ESRD is treated with kidney transplantation, hemodialysis, or peritoneal dialysis. Because diabetic retinopathy and neuropathy progress more rapidly with the onset of renal failure, dialysis is usually instituted early (when serum creatinine reaches about 6 mg/dL) in diabetic nephropathy.

diabetic nephropathy

Diabetic kidney disease The constellation of renal changes attributed to DM–eg Armanni-Ebstein lesion, arterionephrosclerosis, arteriolonephrosclerosis, chronic interstitial nephritis, diabetic glomerulosclerosis, fatty changes in renal tubules, glomerulonephritis, Kimmelstiel-Wilson disease—focal and segmental glomerulosclerosis, nephrotic syndrome, papillary necrosis, and pyelonephritis; DN is the most common cause of ESRD in the West Diagnosis Microalbuminuria Management Antihypertensives–eg, ACE inhibitors–eg, captopril, protect kidneys against further deterioration in type 1 DM, and a 50% ↓ risk in end points–death, dialysis, and transplantation; if renal failure is in an early stage, the Pts are good transplant candidates; ESRD requires dialysis and protein restriction. See End-stage renal disease.

di·a·bet·ic ne·phrop·a·thy

(dī-ă-bet'ik nĕ-frop'ă-thē)
A syndrome occurring in people with diabetes mellitus; associated with damage to blood vessels that supply the glomeruli of the kidney; characterized by albuminuria, hypertension, and progressive renal insufficiency.

diabetic nephropathy

; diabetic kidney disease persistent proteinuria (urinary excretion of >500 mg of protein in 24 hours) with hypertension (secondary to microvascular [arteriolar nephrosclerosis] and macrovascular [arterial nephrosclerosis] disease, and glycation of kidney tissue proteins) associated with long-term diabetes mellitus; a precursor to end-stage renal failure; note: patients with persistent proteinuria tend to have increased incidence of cardiovascular disease (see microalbuminuria)

di·a·bet·ic ne·phrop·a·thy

(dī-ă-bet'ik nĕ-frop'ă-thē)
Syndrome characterized by albuminuria, hypertension, and progressive renal insufficiency.

diabetic nephropathy (nəfro´pəthē´),

n the negative effects on the kidneys or renal system caused by diabetes mellitus. The condition may necessitate dialysis or kidney transplant.
diabetic neuropathy,
n the complications to the nervous system that can be caused by diabetes mellitus, some of which may necessitate amputation or result in oral or facial symptoms.
References in periodicals archive ?
Asia represents the fastest growing region in the diabetic nephropathy market due to the rise in a diabetic population in various countries such as Japan and the Southeast Asian countries.
Transforming growth factor-beta1 (TGF-[beta]1), a multifunctional cytokine, is a key mediator of diabetic nephropathy and increases glomeruli expression of ECM proteins, such as collagen 1, collagen IV, laminin, and fibronectin (Grande et al.
Morphologic changes in diabetic nephropathy affect all 4 renal compartments: glomeruli, tubules, interstitium, and vessels (Figures 1 and 2).
Although some studies showed that physical activity accelerates diabetic nephropathy progression (Matsuoka, 1991), several randomized trials in diabetic animals with proteinuria showed that aerobic exercise training decreased urine protein excretion.
The key change in diabetic nephropathy is an increase in extracellular material, such as thickening of the glomerular basement membrane, expansion of the mesangium, and signs of glomerular fibrosis.
An economic analysis of captopril in the treatment of diabetic nephropathy.
Furthermore, the fetal malformation rate is 25% in diabetic nephropathy patients with poor glycemic control; this can be reduced to less than 8% with prepregnancy counseling.
This result, along with findings of the DCCT and studies performed in Scandinavia, suggests that any program resulting in sustained lowering of blood glucose levels will be beneficial to patients in the early stages of diabetic nephropathy.
In this study, the drug reduced the consequences of diabetic nephropathy by improving the survival and reducing the need for dialysis or kidney transplantation in all the patients receiving it, regardless of the degree of kidney impairment at the beginning of the study.
It covers active pipeline molecules under development in various stages of clinical trials, preclinical research, and drug discovery for Diabetes Mellitus - Type 1, Diabetes Mellitus - Type 2, Diabetic Macular Edema, Diabetic Nephropathy, Diabetic Retinopathy, Dyslipidemia, Lysosomal Storage Diseases, and Obesity.
com)-- The latest market research report added to the repository of Market Research Reports Search Engine (MRRSE) states that the diabetic nephropathy market will report a moderate CAGR at 5.