Diabetic nephropathy medical therapy: Difference between revisions

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** Dilatation of systemic and renal arterioles, increasing [[renal blood flow]].
** Dilatation of systemic and renal arterioles, increasing [[renal blood flow]].
** Rise in [[kinins]] which is also responsible for some of the side effects such as dry cough.[http://www.ksu.edu.sa/sites/Colleges/Medicine/Lists/Medical%20Subjects/Flat.aspx?RootFolder=http%3a%2f%2fwww%2eksu%2eedu%2esa%2fsites%2fColleges%2fMedicine%2fLists%2fMedical%20Subjects%2fDiabetes%20Mellitus%20and%20Angiotensin%20Converting%20Enzyme%20Inhibitors&FolderCTID=0x01200200CEDE56CEF8D11C46824F2F6116DF88AA]
** Rise in [[kinins]] which is also responsible for some of the side effects such as dry cough.[http://www.ksu.edu.sa/sites/Colleges/Medicine/Lists/Medical%20Subjects/Flat.aspx?RootFolder=http%3a%2f%2fwww%2eksu%2eedu%2esa%2fsites%2fColleges%2fMedicine%2fLists%2fMedical%20Subjects%2fDiabetes%20Mellitus%20and%20Angiotensin%20Converting%20Enzyme%20Inhibitors&FolderCTID=0x01200200CEDE56CEF8D11C46824F2F6116DF88AA]
** [[ACE inhibitors]] and [[ARB's]] slow the progression of renal damage from [[diabetes]] to overt renal failure. It is recommended that all patients with [[type I diabetes mellitus|type I]] and [[type II diabetes mellitus]] with [[microalbuminuria]] on routine urine screening should be on [[ACE inhibitors]].
* [[Urinary tract]] and other [[infections]] are common and can be treated with appropriate [[antibiotics]].
* [[Urinary tract]] and other [[infections]] are common and can be treated with appropriate [[antibiotics]].
[[Dialysis]] may be necessary once end-stage renal disease develops. At this stage, a [[kidney transplantation]] must be considered. Another option for type 1 diabetes patients is a combined kidney-pancreas transplant.
[[Dialysis]] may be necessary once end-stage renal disease develops. At this stage, a [[kidney transplantation]] must be considered. Another option for type 1 diabetes patients is a combined kidney-pancreas transplant.

Revision as of 01:40, 22 January 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The goals of treatment are to slow the progression of kidney damage and control related complications. The main treatment, once proteinuria is established, is ACE inhibitor drugs, which usually reduces glomerular hypertension, proteinuria levels, systemic hypertension and slows the progression of diabetic nephropathy.

Medical Therapy

Dialysis may be necessary once end-stage renal disease develops. At this stage, a kidney transplantation must be considered. Another option for type 1 diabetes patients is a combined kidney-pancreas transplant. C-peptide, a by-product of insulin production, may provide new hope for patients sufering from diabetic nephropathy [1] [2].

Drug interaction

Patients with diabetic nephropathy should avoid taking the following drugs:

References

  1. C-peptide is a bioactive peptide. [Diabetologia. 2007] - PubMed Result
  2. Wahren J, Ekberg K, Jörnvall H (2007). "C-peptide is a bioactive peptide". Diabetologia. 50 (3): 503–9. doi:10.1007/s00125-006-0559-y. PMID 17235526.

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