Difference between revisions of "DIABETIC NEPHROPATHY"
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==Reference(s)== | ==Reference(s)== | ||
Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. | Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.] | ||
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.] | |||
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy. | <br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy. | ||
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021]. | <br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021]. | ||
Latest revision as of 20:03, 13 March 2023
SUMMARY
1. May be associated with hyporeninemic hypoaldosteronism and Type 4 RTA.
2. The risk of nephropathy is the same, regardless of whether patients have Type 1 or 2 diabetes, in most cases, retinopathy precedes nephropathy.
3. Risk factors - age, race, genetics, obesity, smoking, BP, GFR, glycemic control, OCP use.
4. Renal biopsy classically shows expansion of the mesangium, thickening of the GBM, and sclerosis of the glomeruli (termed the Kimmelstiei-Wilson lesion).
5. 2 phases - preclinical phase with microalbuminuria, can be detected by measuring random urine albumin:creatinine ratio. Clinical phase with nephrotic syndrome.
6. Control of HTN (to < 140/90 with an ACEI/ARB), glycemia (HbA1c < 7), weight reduction & treatment of hyperlipidemia slows the rate of progression.
7. As renal function decreases, insulin requirements decrease (2° to decreased metabolism by the kidneys).
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
