Diabetic nephropathy: associated risk factors in renal deterioration
- Dhruv K. Singh
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Diabetic Nephropathy (DN) is now recognised as the leading cause of end stage renal disease (ESRD) and contributes between 20 and 40 % of patients with chronic kidney disease on renal replacement therapy (dialysis), worldwide . Clinically, microalbuminuria is considered as the earliest sign of evolving DN, which may become persistent and progressive, leading to proteinuria due to combination of several factors such as chronic hyperglycemia, uncontrolled hypertension, ethnicity, family history of renal disease, lack of early intervention and/or suboptimal glycemic control .
Established DN is defined as presence of persistent proteinuria of >0.5 gm/day, hypertension and a progressive decline in the glomerular filtration rate (GFR), leading to ESRD . Traditionally, the initiation and progression of diabetic nephropathy has been described to go through five different stages such as glomerular hyperfiltration, incipient nephropathy, microalbuminuria, overt proteinuria and end-stage ...
- Hakim FA, Pflueger A. Role of oxidative stress in diabetic kidney disease. Med Sci Monit. 2010;16:RA37–48.
- Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med. 1984;310:356–60. CrossRef
- Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH. Progression of diabetic nephropathy. Kidney Int. 2001;59:702–9. CrossRef
- Mogensen CE, Christensen CK, Vittinghus E. The stages in diabetic renal disease. With emphasis on the stage of incipient diabetic nephropathy. Diabetes. 1983;32 Suppl 2:64–78.
- Unnikrishnan RI, Rema M, Pradeepa R, Deepa M, Shanthirani CS, Deepa R, et al. Prevalence and risk factors of diabetic nephropathy in an urban South Indian population: the Chennai Urban Rural Epidemiology Study (CURES 45). Diabetes Care. 2007;30:2019–24. CrossRef
- Hovind P, Tarnow L, Rossing P, Jensen BR, Graae M, Torp I, et al. Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort study. BMJ. 2004;328:1105. CrossRef
- Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003;63:225–32. CrossRef
- Remuzzi G, Schieppati A, Ruggenenti P. Clinical practice. Nephropathy in patients with type 2 diabetes. N Engl J Med. 2002;346:1145–51. CrossRef
- Hasslacher C, Ritz E, Wahl P, Michael C. Similar risks of nephropathy in patients with type I or type II diabetes mellitus. Nephrol Dial Transplant. 1989;4:859–63.
- Nosadini R, Velussi M, Brocco E, Bruseghin M, Abaterusso C, Saller A, et al. Course of renal function in type 2 diabetic patients with abnormalities of albumin excretion rate. Diabetes. 2000;49:476–84. CrossRef
- Rossing K, Christensen PK, Hovind P, Tarnow L, Rossing P, Parving HH. Progression of nephropathy in type 2 diabetic patients. Kidney Int. 2004;66:1596–605. CrossRef
- Meguro S, Shigihara T, Kabeya Y, Tomita M, Atsumi Y. Increased risk of renal deterioration associated with low e-GFR in type 2 diabetes mellitus only in albuminuric subjects. Intern Med. 2009;48:657–63. CrossRef
- MacIsaac RJ, Tsalamandris C, Panagiotopoulos S, Smith TJ, McNeil KJ, Jerums G. Nonalbuminuric renal insufficiency in type 2 diabetes. Diabetes Care. 2004;27:195–200. CrossRef
- Thomas MC, MacIsaac RJ, Jerums G, Weekes A, Moran J, Shaw JE, et al. Nonalbuminuric renal impairment in type 2 diabetic patients and in the general population (national evaluation of the frequency of renal impairment cO-existing with NIDDM [NEFRON] 11). Diabetes Care. 2009;32:1497–502. CrossRef
- Dalla VM, Saller A, Bortoloso E, Mauer M, Fioretto P. Structural involvement in type 1 and type 2 diabetic nephropathy. Diabetes Metab. 2000;26 Suppl 4:8–14.
- Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR. Risk factors for renal dysfunction in type 2 diabetes: U.K. Prospective Diabetes Study 74. Diabetes. 2006;55:1832–9. CrossRef
- Mogensen CE, Christensen CK. Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med. 1984;311:89–93. CrossRef
- Perkins BA, Ficociello LH, Silva KH, Finkelstein DM, Warram JH, Krolewski AS. Regression of microalbuminuria in type 1 diabetes. N Engl J Med. 2003;348:2285–93. CrossRef
- Singh DK, Winocour P, Farrington K. Oxidative stress in early diabetic nephropathy: fueling the fire. Nat Rev Endocrinol. 2011;7:176–84. CrossRef
- Goicoechea M, de Vinuesa SG, Verdalles U, Ruiz-Caro C, Ampuero J, Rincon A, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol. 2010;5:1388–93. CrossRef
- Cave AC, Brewer AC, Narayanapanicker A, Ray R, Grieve DJ, Walker S, et al. NADPH oxidases in cardiovascular health and disease. Antioxid Redox Signal. 2006;8:691–728. CrossRef
- Bagby SP. Diabetic nephropathy and proximal tubule ROS: challenging our glomerulocentricity. Kidney Int. 2007;71:1199–202. CrossRef
- Sandesh M, Kiran K, Jyoti M. Diabetic nephropathy and associated risk factors for renal deterioration. Int J Diab Dev Countries. 2012;32:52–59.
- Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002;39:257–65. CrossRef
- Stephens JW, Khanolkar MP, Bain SC. The biological relevance and measurement of plasma markers of oxidative stress in diabetes and cardiovascular disease. Atherosclerosis. 2009;202:321–9. CrossRef
- Diabetic nephropathy: associated risk factors in renal deterioration
International Journal of Diabetes in Developing Countries
Volume 32, Issue 3 , pp 113-115
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- Dhruv K. Singh (1)
- Author Affiliations
- 1. JUST Diabetes, 201 Sharyans Odeus, Near Balaji Telefilms, Off New Link Road, Andheri (West), Mumbai, 400053, India