Diabetic nephropathy: Difference between revisions
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== Diabetic nephropathy == | {{SI}} | ||
{{Infobox medical condition | |||
| name = Diabetic nephropathy | |||
| image = [[File:Nodular_glomerulosclerosis.jpeg|250px]] | |||
| caption = Nodular glomerulosclerosis, a characteristic lesion of diabetic nephropathy | |||
| field = [[Nephrology]] | |||
| synonyms = Diabetic kidney disease | |||
| symptoms = [[Proteinuria]], [[hypertension]], [[edema]], [[fatigue]] | |||
| complications = [[Chronic kidney disease]], [[end-stage renal disease]], [[cardiovascular disease]] | |||
| onset = Typically 5-10 years after onset of [[diabetes mellitus]] | |||
| duration = Chronic | |||
| types = [[Type 1 diabetes]], [[Type 2 diabetes]] | |||
| causes = [[Diabetes mellitus]] | |||
| risks = Poor [[glycemic control]], [[hypertension]], [[smoking]], [[genetic predisposition]] | |||
| diagnosis = [[Urinalysis]], [[blood test]]s, [[kidney biopsy]] | |||
| differential = [[Hypertensive nephropathy]], [[glomerulonephritis]], [[polycystic kidney disease]] | |||
| prevention = [[Blood sugar control]], [[blood pressure management]], [[lifestyle modification]] | |||
| treatment = [[ACE inhibitors]], [[angiotensin II receptor blockers]], [[dietary changes]], [[dialysis]], [[kidney transplant]] | |||
| medication = [[ACE inhibitors]], [[ARBs]], [[statins]] | |||
| prognosis = Progressive without treatment, can lead to [[end-stage renal disease]] | |||
| frequency = Affects 20-40% of patients with diabetes | |||
}} | |||
Diabetic nephropathy, also called kidney disease is a type of kidney disease caused by [[diabetes]]. | Diabetic nephropathy, also called kidney disease is a type of kidney disease caused by [[diabetes]]. | ||
== Diabetes and kidney disease == | == Diabetes and kidney disease == | ||
Diabetes is the leading cause of kidney disease - about 1 in 4 adults with diabetes has kidney disease. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. | Diabetes is the leading cause of kidney disease - about 1 in 4 adults with diabetes has kidney disease. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage. | ||
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== Other names == | == Other names == | ||
Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. | Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. | ||
[[File:Blausen 0310 DiabeticNephropathy.png|alt=Diabetic Nephropathy|thumb|'''Diabetic Nephropathy''']] | [[File:Blausen 0310 DiabeticNephropathy.png|alt=Diabetic Nephropathy|left|thumb|'''Diabetic Nephropathy''']] | ||
== Pathophysiology == | == Pathophysiology == | ||
High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they | High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. | ||
== Signs and symptoms == | == Signs and symptoms == | ||
Most people with diabetic kidney disease do not have symptoms, especially in the early stages. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Symptoms such as the following may be seen in the later stages. | Most people with diabetic kidney disease do not have symptoms, especially in the early stages. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Symptoms such as the following may be seen in the later stages. | ||
[[File:Diabetic glomerulosclerosis (7) PAM.jpg|alt=Diabetic glomerulosclerosis|thumb|Diabetic glomerulosclerosis]] | [[File:Diabetic glomerulosclerosis (7) PAM.jpg|alt=Diabetic glomerulosclerosis|left|thumb|Diabetic glomerulosclerosis]] | ||
* [[edema]]: swelling, usually around the [[human eye|eye]]s in the mornings; later, general body swelling may result, such as swelling of the legs | * [[edema]]: swelling, usually around the [[human eye|eye]]s in the mornings; later, general body swelling may result, such as swelling of the legs | ||
* Foamy appearance or excessive frothing of the urine (caused by the proteinuria) | * Foamy appearance or excessive frothing of the urine (caused by the proteinuria) | ||
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* [[Headache]] | * [[Headache]] | ||
* [[Hiccup]]s | * [[Hiccup]]s | ||
== Investigations == | == Investigations == | ||
* BUN, Creatinine | * BUN, Creatinine | ||
| Line 44: | Line 58: | ||
* Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual. | * Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual. | ||
* Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are. | * Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are. | ||
== Stages == | == Stages == | ||
{| class="wikitable" style="float:right; margin-left:5px" | {| class="wikitable" style="float:right; margin-left:5px" | ||
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|- | |- | ||
|Stage 1 | |Stage 1 | ||
| style="text-align:center" | | | style="text-align:center" |‚â• 90 | ||
|- | |- | ||
|Stage 2 | |Stage 2 | ||
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| style="text-align:center" |< 15 | | style="text-align:center" |< 15 | ||
|} | |} | ||
===Staging=== | ===Staging=== | ||
To stage the degree of damage in this (and any) kidney disease, the serum creatinine is determined and used to calculate the estimated glomerular filtration rate ([[Estimated Glomerular Filtration Rate|eGFR]]). Normal eGFR is equal to or greater than 90ml/min/1.73 m<sup>2</sup>.<ref>{{Cite web|title=Glomerular filtration rate: MedlinePlus Medical Encyclopedia|url=https://www.nlm.nih.gov/medlineplus/ency/article/007305.htm|website=www.nlm.nih.gov|access-date=2015-07-02}}</ref> | To stage the degree of damage in this (and any) kidney disease, the serum creatinine is determined and used to calculate the estimated glomerular filtration rate ([[Estimated Glomerular Filtration Rate|eGFR]]). Normal eGFR is equal to or greater than 90ml/min/1.73 m<sup>2</sup>.<ref>{{Cite web|title=Glomerular filtration rate: MedlinePlus Medical Encyclopedia|url=https://www.nlm.nih.gov/medlineplus/ency/article/007305.htm|website=www.nlm.nih.gov|access-date=2015-07-02}}</ref> | ||
== Treatment == | == Treatment == | ||
* '''Prevention''' - Prevention is better than cure - so preventing diabetes and managing blood sugars well reduces the risk. | * '''Prevention''' - Prevention is better than cure - so preventing diabetes and managing blood sugars well reduces the risk. | ||
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* '''Dialysis''' - or other renal replacement therapy | * '''Dialysis''' - or other renal replacement therapy | ||
* '''Kidney transplant''' - kidney transplant with a healthy donor kidney | * '''Kidney transplant''' - kidney transplant with a healthy donor kidney | ||
== Prevention == | == Prevention == | ||
* Control diabetes better | * Control diabetes better | ||
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* Be more active | * Be more active | ||
* Lose weight if overweight | * Lose weight if overweight | ||
{{Glomerular disease}} | {{Glomerular disease}} | ||
{{Disease of the pancreas and glucose metabolism}} | {{Disease of the pancreas and glucose metabolism}} | ||
{{Diabetes}} | {{Diabetes}} | ||
{{Authority control}} | {{Authority control}} | ||
{{DEFAULTSORT:Diabetic Nephropathy}} | {{DEFAULTSORT:Diabetic Nephropathy}} | ||
[[Category:Kidney diseases]] | [[Category:Kidney diseases]] | ||
[[Category:Vascular diseases]] | [[Category:Vascular diseases]] | ||
[[Category:Diabetes]] | [[Category:Diabetes]] | ||
Latest revision as of 18:29, 5 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Diabetic nephropathy | |
|---|---|
| |
| Synonyms | Diabetic kidney disease |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Proteinuria, hypertension, edema, fatigue |
| Complications | Chronic kidney disease, end-stage renal disease, cardiovascular disease |
| Onset | Typically 5-10 years after onset of diabetes mellitus |
| Duration | Chronic |
| Types | Type 1 diabetes, Type 2 diabetes |
| Causes | Diabetes mellitus |
| Risks | Poor glycemic control, hypertension, smoking, genetic predisposition |
| Diagnosis | Urinalysis, blood tests, kidney biopsy |
| Differential diagnosis | Hypertensive nephropathy, glomerulonephritis, polycystic kidney disease |
| Prevention | Blood sugar control, blood pressure management, lifestyle modification |
| Treatment | ACE inhibitors, angiotensin II receptor blockers, dietary changes, dialysis, kidney transplant |
| Medication | ACE inhibitors, ARBs, statins |
| Prognosis | Progressive without treatment, can lead to end-stage renal disease |
| Frequency | Affects 20-40% of patients with diabetes |
| Deaths | N/A |
Diabetic nephropathy, also called kidney disease is a type of kidney disease caused by diabetes.
Diabetes and kidney disease[edit]
Diabetes is the leading cause of kidney disease - about 1 in 4 adults with diabetes has kidney disease. Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.
Other names[edit]
Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy.
Pathophysiology[edit]
High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys.
Signs and symptoms[edit]
Most people with diabetic kidney disease do not have symptoms, especially in the early stages. The only way to know if you have diabetic kidney disease is to get your kidneys checked. Symptoms such as the following may be seen in the later stages.
_PAM.jpg)
- edema: swelling, usually around the eyes in the mornings; later, general body swelling may result, such as swelling of the legs
- Foamy appearance or excessive frothing of the urine (caused by the proteinuria)
- Unintentional weight gain
- anorexia (poor appetite)
- Nausea and vomiting
- Malaise (general ill feeling)
- fatigue
- Headache
- Hiccups
Investigations[edit]
- BUN, Creatinine
- Glomerular filtration rate (GFR) - one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
- Creatinine blood and urine tests - check the levels of creatinine, a waste product that your kidneys remove from your blood
- Albumin urine test - checks for albumin, a protein that can pass into the urine if the kidneys are damaged
- Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
- Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.
Stages[edit]
| CKD Stage | eGFR level (mL/min/1.73 m2) |
|---|---|
| Stage 1 | ‚â• 90 |
| Stage 2 | 60–89 |
| Stage 3 | 30–59 |
| Stage 4 | 15–29 |
| Stage 5 | < 15 |
Staging[edit]
To stage the degree of damage in this (and any) kidney disease, the serum creatinine is determined and used to calculate the estimated glomerular filtration rate (eGFR). Normal eGFR is equal to or greater than 90ml/min/1.73 m2.<ref>
Glomerular filtration rate: MedlinePlus Medical Encyclopedia(link). www.nlm.nih.gov.
Accessed 2015-07-02.
</ref>
Treatment[edit]
- Prevention - Prevention is better than cure - so preventing diabetes and managing blood sugars well reduces the risk.
- Medications - angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers can help reduce kidney damage.
- Dialysis - or other renal replacement therapy
- Kidney transplant - kidney transplant with a healthy donor kidney
Prevention[edit]
- Control diabetes better
- Control blood pressure
- Do not smoke
- Follow your diabetes eating plan
- Reduce salt
- Be more active
- Lose weight if overweight
| Disease of the kidney glomerules | ||||||
|---|---|---|---|---|---|---|
|
| Disease of the pancreas and glucose metabolism | ||||
|---|---|---|---|---|
|
| Diabetes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
