Diabetic Nephropathy (Diabetic Kidney Disease) – Diabetes Complications

by Carlo Raj, MD

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    We will move on to diabetic nephropathy. I showed you images, we had a discussion of diabetic nephropathy in nephrology. Make sure that we are complete. 20-30 percent of all patients with DM develop nephropathy, that’s a huge percentage. The most common cause of renal failure is diabetic nephropathy. The changes that are taking place, if you remember with nephropathy include both the blood vessels and then also within the mesangium, right? What happens first? It is the blood vessels first and if you have arterioles that have been affected then you call this Hyaline Arteriosclerosis, hyalinization. And for the most part, if there is diabetic damage to the kidney, one of the first signs that you will be looking for upon urinalysis called microalbuminuria, microalbuminuria. What are you going to put this patient on immediately to preserve the functioning of the kidney? ACE inhibitor. ACE inhibitor is renal protective and the reason for that is because it removes the affective angiotensin 2 which prefers to work upon the efferent arterial vasoconstriction. Unbelievably, in diabetic nephropathy tends to develop hyaline arteriosclerosis on the efferent side. And so, therefore, if you constrict the efferent pathologically, you are then causing damage to the glomerulus. So, why don’t we then ease up some of that stress and that constriction of the efferent arterial by giving an ACE inhibitor? Screen with microalbuminuria, begin shortly after type 2 diabetes and 5 years after type 1. Annually, they are after… it is important that you are always paying attention to retinopathy, nephropathy, retinopathy, nephropathy and obviously neuropathy, the 3Ns. Elevated use of micro albumin maybe secondary to fever, exercise, infection. So, other, other causes or differentials that may result in microalbuminuria, keep that in mind. However, diabetes mellitus extremely important to monitor. ACE inhibitor removes the...

    About the Lecture

    The lecture Diabetic Nephropathy (Diabetic Kidney Disease) – Diabetes Complications by Carlo Raj, MD is from the course Pancreatic Disease & Diabetes.

    Included Quiz Questions

    1. ACE Inhibitors
    2. Beta-blockers
    3. Digoxin
    4. Thiazide
    5. Corticosteroids
    1. Microalbumin
    2. Glucose
    3. Ketone bodies
    4. Protein
    5. Leukocytes
    1. Kimmelstein-Wilson nodules
    2. IgA depostion
    3. Armanni-Ebstein lesion
    4. Mesangial microalbumin deposition
    5. JG cell atrophy

    Author of lecture Diabetic Nephropathy (Diabetic Kidney Disease) – Diabetes Complications

     Carlo Raj, MD

    Carlo Raj, MD

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