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International Urology and Nephrology

, Volume 34, Issue 2, pp 257–264 | Cite as

Diabetic nephropathy-pathophysiology and management

  • Judy Tan Shumway
  • Steven R. Gambert
Article

Abstract

Diabetes mellitus is the leading cause ofend-stage renal disease in the United States. Between 1996 and 2001, the prevalence ofdiabetes in the Medicare population increasedby 31%. Patients with diabetes account forapproximately one-third of all cases ofend-stage renal disease (ESRD). This number isexpected to rise dramatically as a result ofthe growing incidence of diabetes and the agingpopulation. A major complication of diabetesincludes end-stage renal disease as a resultfrom diabetic nephropathy. The earliestclinical evidence that nephropathy exists isthe appearance of low, yet abnormal, levels ofalbumin in the urine, referred to asmicroalbuminuria. This can progress toproteinuria representing overt diabeticnephropathy. Prevention remains the best way toreduce mortality and maintain a high quality oflife in these individuals as recent clinicaltrials confirm that it is possible to not onlyslow down the progression of diabeticnephropathy, but even prevent it from becominga significant problem. This article reviewsthe pathogenesis, diagnostic screening, andtreatment strategies of diabetic nephropathy.

Diabetic complications Diabetic nephropathy Microalbuminuria 

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Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Judy Tan Shumway
    • 1
  • Steven R. Gambert
    • 1
  1. 1.Johns Hopkins University School of Medicine and Sinai Hospital of BaltimoreBaltimoreUSA

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