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Natural Course (Stages/Evidence-Based Discussion)

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Diabetes and Kidney Disease

Abstract

Changes in kidney function can be noted right at the diagnosis of diabetes mellitus (DM). This chapter describes the similarities and differences of the five stages of natural course of diabetic kidney disease (DKD) in type 1 DM (T1DM) and type 2 DM (T2DM). Stage 1 is called hyperfiltration-hypertrophy phase. Stage 2 is named as the silent or normoalbuminuric stage as it is not detected clinically. Stage 3 is termed microalbuminuria or incipient diabetic nephropathy and it is detected clinically. Stage 4 is called macroalbuminuria or overt diabetic nephropathy (ODN) and the UAE is in macroalbuminuria range. Although GFR can be within normal range early in this phase, it continues to decline as the stage progresses. Lastly, stage 5 is called end-stage renal disease (ESRD) or uremia. This stage is due to advanced diabetic nephropathy and requires initiation of renal replacement therapy for survival.

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Authors and Affiliations

  1. Department of Medicine, Section of Endocrinology and Metabolism, Tulane University Health Sciences Center and Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA

    Dragana Lovre

  2. Translational Research Institute, Advent Health, Orlando, FL, USA

    Tina Kaur Thethi

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  2. Tina Kaur Thethi
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Correspondence to Dragana Lovre .

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  1. Section of Nephrology, University of Illinois at Chicago/Advocate Christ Medical Center,, Oak Lawn, IL, USA

    Edgar V. Lerma

  2. Nephrology Section, Tulane University, New Orleans, LA, USA

    Vecihi Batuman

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Lovre, D., Thethi, T.K. (2022). Natural Course (Stages/Evidence-Based Discussion). In: Lerma, E.V., Batuman, V. (eds) Diabetes and Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-86020-2_4

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  • DOI: https://doi.org/10.1007/978-3-030-86020-2_4

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