Volume : 11, Issue : 02, February – 2024

Title:

A REVIEW ARTICLE ON DIABETIC NEPHROPATHY

Authors :

Dr. B. Aruna *, B. Vasundhara

Abstract :

Diabetic nephropathy is one of the most feared diabetic chronic microvascular complications of type 1 and type 2 diabetes.it is also known as diabetic kidney disease. and is defined by increased urinary albumin excretion in the absence of other renal diseases. The chronic hyperglycaemia and high blood pressure are the main risk factors for the development of DN. The stages of diabetic nephropathy: Stage1kidney damage present but normal kidney function and a GFR of 90%or above and stage 2- kidney damage with some loss of function and a GFR of 60-89%. Stage3-milld to severe loss of function and a GFR of 30-59%. Stage4- severe loss of function and GFT of 15-29%. The major causes of end-stage renal disease. if what happens to the kidney in diabetic nephropathy is high blood glucose level can damage the small blood vessels and tiny filters in your kidneys. the mechanism of proteinuria is may be initiated by promoting increased production of reactive oxygen species. the induction of AGE-induced proinflammatory signaling and increased glomerular capillary pressure and hypofiltration. pathogenesis of DN is progressive nerve fiber loss. The aim of this discuss the methods of early screening and diagnosis of diabetic nephropathy and the therapeutic strategies that promote Reno and cardio protection in this high risk group of patients, in order to reduce the incidence of diabetic nephropathy and it’s associated cardiovascular mortality. The prevention of DN is the treatment of known risk factors hypertension, hyperglycaemia, smoking and also CV disease should be vigorous treated. The review focus on the role of inflammation and oxidative stress in pathogenesis of DN, approaches to diagnose in classic and NP-DN, current and emerging and therapeutic interventions.
Keywords: Diabetic nephropathy, albumin excretion hyperglycemia , cardio vascular mortality , proteinuria

Cite This Article:

Please cite this article in press B. Aruna et al., A Review Article On Diabetic Nephropathy, Indo Am. J. P. Sci, 2024; 11 (02).

Number of Downloads : 10

References:

1. Ahmad T., Ulhaq I., Mawani M., Islam N. Microalbuminuria in type-2 diabetes mellitus; the tip of iceberg of diabetic complications. Pak. J. Med. Sci. 2017; 33:519–523. Doi: 10.12669/pjms.333.12537.
2. Ahola K. A. J., Forsblom C., Groop P. H. Adherence to special diets and its association with meeting the nutrient recommendations in individuals with type 1 diabetes. Acta Diabetol . 2018; 55:843–851doi: 10.1007/s00592-018-1159-2.
3. Amalan V., Vijayakumar N. Antihyperglycemic effect of p-coumaric acid on streptozotocin induced diabetic rats. Indian J. Appl. Res.
4. Amalan V., Vijayakumar N., Ramakrishnan A. p-Coumaric acid regulates blood glucose and antioxidant levels in streptozotocin induced diabetic rats. J. Chem. Pharm. Res. 2015; 7:831–839.
5. Anders H. J., Davis J. M., Thurau K. Nephron protection in diabetic kidney disease. N. Engl. J. Med. 2016; 375:2096–2098. Doi: 10.1056/NEJMcibr1608564.
6. Azizi M., Ménard J., Bissery A., Guyenne T. T., Bura-Rivière A. Hormonal and hemodynamic effects of aliskiren and valsartan and their combination in sodium-replete normotensive individuals. Clin. J. M.Sc. 2007; 2:947–955. Doi: 10.2215/CJN.00360107.
7. Berhane A. M., Weil E. J., Knowler W. C., Nelson R. G., Hanson R. L. Albuminuria and estimated glomerular filtration rate as predictors of diabetic end-stage renal disease and death. Clin. J. Am. Soc. Nephrol. 2011; 6:2444–2451. Doi: 10.2215/CJN.00580111
8. International Diabetes Federation. IDF Diabetes Atlas. 6th ed. Brussels, Belgium: International Diabetes Federation; 2013. [Accessed September 2, 2014].
9. Center for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States. Atlanta, GA: US Department of Health and Human Services; 2011. [Accessed September 2, 2014].
10. Tapp RJ, Shaw JE, Zimmet PZ, et al. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab) Am J Kidney Dis. 2004;44(5):792–798.
11. Scott LJ, Warr am JH, Hanna LS, Leffe LM, Ryan L, Krolewski AS. A nonlinear effect of hyperglycaemia and current cigarette smoking are major determinants of the onset of microalbuminuria in type 1 diabetes. Diabetes. 2001;50(12):2842–2849.
12. Rossing P, Hougaard P, Parving HH. Risk factors for development of incipient and overt diabetic nephropathy in type 1 diabetic patients: a 10-year prospective observational study. Diabetes Care. 2002;25(5):859–864.
13. Satko SG, Langefeld CD, Daveigh34 P, Bowden DW, Rich SS, Freedman BI. Nephropathy in siblings of African Americans with overt type 2 diabetic nephropathy. Am J Kidney Dis. 2002;40(3):489–494.
14. Pettitt DJ, Saad MF, Bennett PH, Nelson RG, Knowler WC. Familial predisposition to renal disease in two generations of Pima Indians with type 2 (non-insulin-dependent) diabetes mellitus. Diabetology. 1990;33(7):438–443.
15. Seaquist ER, Goetz FC, Rich S, Barbosa J. Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. N Engl J Med. 1989;320(18):1161–1165.
16. Young BA, Maynard C, Boyko EJ. Racial differences in diabetic nephropathy, cardiovascular disease, and mortality in a national population of veterans. Diabetes Care. 2003;26(8):2392–2399.
17. Smith SR, Sverker LP, Dennis VW. Racial differences in the incidence and progression of renal diseases. Kidney Int. 1991;40(5):815–822.
18. Gall MA, Hougaard P, Borch-Johnsen K, Parving HH. Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study. BMJ. 1997;314(7083):783–788.
19. Mooy art AL, Valk EJ, van Es LA, et al. Genetic associations in diabetic nephropathy: a meta-analysis. diabetology 2011;54(3):544–553.
20. Rabkin R. Diabetic nephropathy. Clin Cornerstone. 2003;5(2):1-11.
21. Diabetes Canada Clinical Practice Guidelines Expert Committee. McFarlane P, Cherney D, Gilbert RE, Senior P. Chronic Kidney Disease in Diabetes. Can J Diabetes. 2018 Apr;42 Supple1:S201-S209.
22. Umanath K, Lewis JB. Update on Diabetic Nephropathy: Core Curriculum 2018. Am J Kidney Dis. 2018 Jun;71(6):884-895.
23. DCCT/EDIC research group. Effect of intensive diabetes treatment on albuminuria in type 1 diabetes: long-term follow-up of the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications study. Lancet Diabetes Endocrinol. 2014 Oct;2(10):793-800.
24. Genuth S, Eastman R, Kahn R, Klein R, Lachin J, Lebovitz H, Nathan D, Vinicio F., American Diabetes Association. Implications of the United Kingdom prospective diabetes study. Diabetes Care. 2003 Jan;26 Suppler1:S28-32.
25. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH, Remizid G, Snap inn SM, Zhang Z, Shahinfar S., RENAAL Study Investigators. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001 Sep 20;345(12):861-9.
26. Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, Ritz E, Atkins RC, Rohde R, Raz I., Collaborative Study Group. Reno protective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001 Sep 20;345(12):851-60.
27. Himmelstein P, Wilson C. Intracapillary lesions in the glomeruli in the kidney. Am J Pathos 1936;12: 83-
28. Mogensen CE. Microalbuminuria, blood pressure and diabetic renal disease: origin and development of ideas. diabetology 1999;42: 263-85.
29. Mogensen CE, Andersen MJ. Increased kidney size and glomerular filtration rate in untreated juvenile diabetes: normalization by insulin-treatment. Diabology 1975;11: 221-4.
30. Rudberg S, Persson B, Dahlquist G. Increased glomerular filtration rate as a predictor of diabetic nephropathy—an 8-year prospective study. Kidney Int1992; 41:
31. Hostetter TH, Reinke HG, Brenner BM. The case for intrarenal hypertension in the initiation and progression of diabetic and other glomerulopathies. Am J Med 1982;72: 375-80.
32. Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med 1984;310: 356-60.
33. Verti GC, Hill RD, Jarrett RJ, Argyropoulos A, Makmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet1982; i: 1430-2.