Diabetic nephropathy
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| Photomicrography of nodular glomerulosclerosis in Kimmelstein-Wilson syndrome. Source: CDC |
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Diabetic nephropathy Microchapters |
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Diabetic nephropathy On the Web |
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American Roentgen Ray Society Images of Diabetic nephropathy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords:: Kimmelstiel-Wilson disease; diabetic glomerulosclerosis; nephropathy-diabetic; diabetic glomerulonephropathy
Overview
Diabetic nephropathy (DN) is characterized by the presence of proteinuria or decreased renal function in patients with diabetes mellitus. Diabetic nephropathy may be early or overt.
Pathophysiology
The hallmark of diabetic nephropathy is mesangial expansion. Nonetheless, diabetic nephropathy is characterized by the presence of abnormalities in the glomeruli, such as glomerular hypertrophy, in the tubules and interstitium, such as tubular atrophy and interstitial fibrosis, and in the blood vessels, such as arteriosclerosis in both the afferent and the efferent renal arteries. Findings on histopathological analysis may be evident very early in diabetes, but are often clinically present approximately 15 years after the onset of metabolic abnormalities. A 2010 classification has been proposed that correlated the histopathological findings with the severity of disease.
Differentiating Diabetic nephropathy from other Diseases
The differential diagnosis of diabetic nephropathy includes a spectrum of nephrotic and nephritic renal diseases and other systemic diseases with renal manifestations. The diagnosis of diabetic nephropathy should not be directly presumed on the basis of presence of renal disease in a diabetic patient. The gold standard for the diagnosis of diabetic nephropathy is renal biopsy.
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Biopsy | CT | MRI | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Case Studies
External links
- Diabetic nephropathy. MedlinePlus Medical Encyclopedia. Text from this public domain article was partially used here.
de:Diabetische Nephropathie he:סוכרת כלייתית sr:Дијабетесна нефропатија fi:Diabeettinen nefropatia sv:Diabetesnefropati