Diabetic nephropathy

diabetic kidney diseasenephropathydiabetic nephropathiesdiabetesArmanni–Ebstein nephropathic changediabetes mellitus with renal manifestationsdiabetes-induced kidney problemsdiabetic glomerulosclerosiskidney damageKidney damage due to diabetes
Diabetic nephropathy (DN), also known as diabetic kidney disease, is the chronic loss of kidney function occurring in those with diabetes mellitus.wikipedia
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Chronic kidney disease

chronic renal failurerenal insufficiencyend-stage renal disease
Likewise, the estimated glomerular filtration rate (eGFR) may progressively fall from a normal of over 90 ml/min/1.73m 2 to less than 15, at which point the patient is said to have end-stage kidney disease (ESKD).
Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.

Angiotensin II receptor blocker

angiotensin II receptor antagonistangiotensin receptor blockersangiotensin receptor blocker
Treatment with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB), which dilates the arteriole exiting the glomerulus, thus reducing the blood pressure within the glomerular capillaries, which may slow (but not stop) progression of the disease.
Their main uses are in the treatment of hypertension (high blood pressure), diabetic nephropathy (kidney damage due to diabetes) and congestive heart failure.

Proteinuria

protein in the urineproteinProtein loss in the urine
Protein loss in the urine due to damage to the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) and result in the nephrotic syndrome. The status of DN may be monitored by measuring two values: the amount of protein in the urine - proteinuria; and a blood test called the serum creatinine.
Diabetes mellitus (diabetic nephropathy)

Nephrotic syndrome

a serious kidney disorderGlomerulosclerosisidiopathic nephrotic syndrome
Protein loss in the urine due to damage to the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) and result in the nephrotic syndrome.
Diabetic nephropathy: is a complication that occurs in some diabetics. Excess blood sugar accumulates in the kidney causing them to become inflamed and unable to carry out their normal function. This leads to the leakage of proteins into the urine.

Nephron

nephronsrenal tubulerenal tubules
This is followed by multiple changes in the filtration units of the kidneys, the nephrons.
Glomerular diseases include diabetic nephropathy, glomerulonephritis and IgA nephropathy; renal tubular diseases include acute tubular necrosis and polycystic kidney disease.

Diabetes mellitus

diabetesdiabeticdiabetics
Diabetic nephropathy (DN), also known as diabetic kidney disease, is the chronic loss of kidney function occurring in those with diabetes mellitus.
Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation.

Kidney transplantation

kidney transplantrenal transplantrenal transplantation
Affected individuals with end-stage kidney disease often require hemodialysis and eventually kidney transplantation to replace the failed kidney function.
This is done in patients with diabetes mellitus type 1, in whom the diabetes is due to destruction of the beta cells of the pancreas and in whom the diabetes has caused renal failure (diabetic nephropathy).

ACE inhibitor

angiotensin converting enzyme inhibitorangiotensin-converting enzyme inhibitorACE inhibitors
Treatment with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB), which dilates the arteriole exiting the glomerulus, thus reducing the blood pressure within the glomerular capillaries, which may slow (but not stop) progression of the disease.
Kidney complications of diabetes mellitus (diabetic nephropathy)

Mesangial cell

mesangial cellsmesangial
The pathophysiology of the glomerulus in DN can best be understood by considering the three involved cells as a unit: the endothelial cell, the podocyte, and the mesangial cell.
The expansion of mesangial matrix is one characteristic of diabetic nephropathy although it also involves other cells in interaction including podocytes and endothelial cells.

Hyperbaric medicine

hyperbaric oxygen therapyhyperbarichyperbaric oxygen
Hyperbaric medicine
Diabetically derived illness, such as short-term relief of diabetic foot, diabetic retinopathy, diabetic nephropathy;

Glomerulus (kidney)

glomerulusglomeruliglomerular
These changes damage the kidney's glomeruli (networks of tiny blood vessels), which leads to the hallmark feature of albumin in the urine (called albuminuria).
Examples are diabetic kidney disease, glomerulonephritis, and IgA nephropathy.

Transforming growth factor beta

TGF-βTGFβtransforming growth factor-beta
Another relevant factor is diabetes-induced hypoxia, which is an aggravating factor, since it increases interstitial fibrosis, partly by the induction of the synthesis of TGF-β and vascular endothelial growth factor (VEGF), which is mediated by hypoxia-inducing factor-1.
TGF-β/SMAD3 signaling pathway is important in regulating glucose and energy homeostasis and might play a role in diabetic nephropathy.

Albuminuria

macroalbuminuriaalbumin in the urinemany kidney disorders
These changes damage the kidney's glomeruli (networks of tiny blood vessels), which leads to the hallmark feature of albumin in the urine (called albuminuria).
Microalbuminuria (between 30 and 300 mg/24h, mg/l of urine or µg/mg of creatinine ) can be a forerunner of diabetic nephropathy. The term albuminuria is now preferred in Nephrology since there is not a "small albumin" (microalbuminuria) or a "big albumin" (macroalbuminuria). A1 represents normal to mildly increased urinary albumin/creatinine ratio (0 mg/g or < 3 mg/mmmol); A2 represents moderately increased urinary albumin/creatinine ratio (30–300 mg/g or 3–30 mg/mmmol, previously known as microalbuminuria); and A3 reflects severely increased urinary albumin/creatinine ratio >300 mg/g or > 30 mg/mmol).

Glomerulus

glomeruliglomerularglomerular filtration
Protein loss in the urine due to damage to the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) and result in the nephrotic syndrome.

Serum albumin

albuminplasma albuminALB
Protein loss in the urine due to damage to the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) and result in the nephrotic syndrome.

Anasarca

anascarabuild-up of fluidgeneralized body swelling (edema)
Protein loss in the urine due to damage to the glomeruli may become massive, and cause a low serum albumin with resulting generalized body swelling (edema) and result in the nephrotic syndrome.

Efferent arteriole

efferent arteriolesefferentefferent blood stream
Initially, there is constriction of the efferent arterioles and dilation of afferent arterioles, with resulting glomerular capillary hypertension and hyperfiltration; this gradually changes to hypofiltration over time.

Afferent arterioles

afferent arterioleafferent
Initially, there is constriction of the efferent arterioles and dilation of afferent arterioles, with resulting glomerular capillary hypertension and hyperfiltration; this gradually changes to hypofiltration over time.

Basement membrane

basement membranesbasement membrane zonecapillary basement membranes
Concurrently, there are changes within the glomerulus itself: these include a thickening of the basement membrane, a widening of the slit membranes of the podocytes, an increase in the number of mesangial cells, and an increase in mesangial matrix.

Creatinine

serum creatininenormal renal functioncreatinin
The status of DN may be monitored by measuring two values: the amount of protein in the urine - proteinuria; and a blood test called the serum creatinine.

Arteriole

arteriolesarteriolararterial
Treatment with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB), which dilates the arteriole exiting the glomerulus, thus reducing the blood pressure within the glomerular capillaries, which may slow (but not stop) progression of the disease.

Blood pressure

systolic blood pressurediastolic blood pressurearterial blood pressure
Treatment with an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB), which dilates the arteriole exiting the glomerulus, thus reducing the blood pressure within the glomerular capillaries, which may slow (but not stop) progression of the disease.

Glucagon-like peptide-1 receptor agonist

GLP-1 receptor agonistglucagon-like peptide-1 agonistGlP-1
Three classes of diabetes medications – GLP-1 agonists, DPP-4 inhibitors, and SGLT2 inhibitors – are also thought to slow the progression of diabetic nephropathy.

Dipeptidyl peptidase-4 inhibitor

dipeptidyl peptidase-4 (DPP-4) inhibitorDPP-4 inhibitorDipeptidyl peptidase-4 (DPP-4) inhibitors
Three classes of diabetes medications – GLP-1 agonists, DPP-4 inhibitors, and SGLT2 inhibitors – are also thought to slow the progression of diabetic nephropathy.

Gliflozin

gliflozins
Three classes of diabetes medications – GLP-1 agonists, DPP-4 inhibitors, and SGLT2 inhibitors – are also thought to slow the progression of diabetic nephropathy.