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==Overview==
==Overview==
The syndrome was discovered by British [[physician]] Clifford Wilson (1906-1997) and Germany-born American physician Paul Kimmelstiel (1900-1970) and was published for the first time in 1936.
Diabetic nephropathy (DN) is defined as the presence of proteinuria or decreased renal function in patients with diabetes mellitus.<ref name="pmid6738599">{{cite journal| author=Mogensen CE, Christensen CK| title=Predicting diabetic nephropathy in insulin-dependent patients. | journal=N Engl J Med | year= 1984 | volume= 311 | issue= 2 | pages= 89-93 | pmid=6738599 | doi=10.1056/NEJM198407123110204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6738599  }} </ref><ref name="pmid6690964">{{cite journal| author=Mogensen CE| title=Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 6 | pages= 356-60 | pmid=6690964 | doi=10.1056/NEJM198402093100605 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6690964  }} </ref><ref name="pmid21659752">{{cite journal| author=Reutens AT, Atkins RC| title=Epidemiology of diabetic nephropathy. | journal=Contrib Nephrol | year= 2011 | volume= 170 | issue=  | pages= 1-7 | pmid=21659752 | doi=10.1159/000324934 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21659752  }} </ref>
 
===Early Diabetic Nephropathy===
'''Diabetic nephropathy''' (''nephropatia diabetica''), also known as '''Kimmelstiel-Wilson syndrome''' and '''intercapillary glomerulonephritis''', is a progressive [[kidney disease]] caused by [[angiopathy]] of [[capillary|capillaries]] in the [[kidney]] [[glomerulus|glomeruli]]. It is characterized by [[nephrotic syndrome]] and nodular glomerulosclerosis. It is due to longstanding [[diabetes mellitus]], and is a prime cause for [[dialysis]] in many Western countries.
The range of proteinuria in early DN is shown below<ref name="pmid6738599">{{cite journal| author=Mogensen CE, Christensen CK| title=Predicting diabetic nephropathy in insulin-dependent patients. | journal=N Engl J Med | year= 1984 | volume= 311 | issue= 2 | pages= 89-93 | pmid=6738599 | doi=10.1056/NEJM198407123110204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6738599  }} </ref><ref name="pmid6690964">{{cite journal| author=Mogensen CE| title=Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 6 | pages= 356-60 | pmid=6690964 | doi=10.1056/NEJM198402093100605 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6690964  }} </ref><ref name="pmid21659752">{{cite journal| author=Reutens AT, Atkins RC| title=Epidemiology of diabetic nephropathy. | journal=Contrib Nephrol | year= 2011 | volume= 170 | issue=  | pages= 1-7 | pmid=21659752 | doi=10.1159/000324934 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21659752  }} </ref>:
*Males: Microalbuminuria in the range of 30-300 mg/24 hrs or a spot urinary albumin/creatinine ratio of 30-300 mg/g
*Females: Microalbuminuria in the range of 30-300 mg/24 hrs or a spot urinary albumin/creatinine ratio of 20-200 mg/g
===Overt Diabetic Nephropathy===
Overt DN is defined according to the presence of proteinuria or according to renal function.
The following ranges in overt DN are shown below<ref name="pmid6738599">{{cite journal| author=Mogensen CE, Christensen CK| title=Predicting diabetic nephropathy in insulin-dependent patients. | journal=N Engl J Med | year= 1984 | volume= 311 | issue= 2 | pages= 89-93 | pmid=6738599 | doi=10.1056/NEJM198407123110204 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6738599  }} </ref><ref name="pmid6690964">{{cite journal| author=Mogensen CE| title=Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 6 | pages= 356-60 | pmid=6690964 | doi=10.1056/NEJM198402093100605 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6690964  }} </ref><ref name="pmid21659752">{{cite journal| author=Reutens AT, Atkins RC| title=Epidemiology of diabetic nephropathy. | journal=Contrib Nephrol | year= 2011 | volume= 170 | issue=  | pages= 1-7 | pmid=21659752 | doi=10.1159/000324934 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21659752  }} </ref>:
*Proteinuria > 500 mg/24 hrs or albuminuria > 300 mg/24 hrs.
*Estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2


==References==
==References==

Revision as of 18:43, 19 January 2014

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Overview

Diabetic nephropathy (DN) is defined as the presence of proteinuria or decreased renal function in patients with diabetes mellitus.[1][2][3]

Early Diabetic Nephropathy

The range of proteinuria in early DN is shown below[1][2][3]:

  • Males: Microalbuminuria in the range of 30-300 mg/24 hrs or a spot urinary albumin/creatinine ratio of 30-300 mg/g
  • Females: Microalbuminuria in the range of 30-300 mg/24 hrs or a spot urinary albumin/creatinine ratio of 20-200 mg/g

Overt Diabetic Nephropathy

Overt DN is defined according to the presence of proteinuria or according to renal function. The following ranges in overt DN are shown below[1][2][3]:

  • Proteinuria > 500 mg/24 hrs or albuminuria > 300 mg/24 hrs.
  • Estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2

References

  1. ↑ 1.0 1.1 1.2 Mogensen CE, Christensen CK (1984). "Predicting diabetic nephropathy in insulin-dependent patients". N Engl J Med. 311 (2): 89–93. doi:10.1056/NEJM198407123110204. PMID 6738599.
  2. ↑ 2.0 2.1 2.2 Mogensen CE (1984). "Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes". N Engl J Med. 310 (6): 356–60. doi:10.1056/NEJM198402093100605. PMID 6690964.
  3. ↑ 3.0 3.1 3.2 Reutens AT, Atkins RC (2011). "Epidemiology of diabetic nephropathy". Contrib Nephrol. 170: 1–7. doi:10.1159/000324934. PMID 21659752.
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