Diabetic Nephropathy

Diabetic nephropathy is a leading microvascular complication of diabetes and a major cause of end-stage renal disease. It evolves through stages: glomerular hyperfiltration, silent basement-membrane thickening, incipient nephropathy (microalbuminuria), overt nephropathy (macroalbuminuria, nodular Kimmelstiel-Wilson sclerosis), and progressive renal failure. Risk: poor glycemic control, hypertension, smoking, dyslipidemia, family history.

Common Symptoms

Microalbuminuria; progressive proteinuria; edema; hypertension; declining eGFR; uremia in late stage

Causes and Pathogenesis

Chronic hyperglycemia causes glomerular basement-membrane thickening, mesangial expansion, nodular sclerosis, and glomerular hypertension; hemodynamic and metabolic injury destroys filtration.

Treatment

Intensive glycemic control; ACE inhibitor/ARB for hypertension and proteinuria; SGLT2 inhibitors; low-protein diet; dialysis/transplant for ESRD; manage lipids and smoking cessation

Preventive Measures

Annual urine albumin/ creatinine screening; tight glycemic and BP control; smoking cessation; avoid nephrotoxins.

Department to Visit

It is recommended to visit the Nephrology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.