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St Vincent Declaration, 1994: Guidelines for the Prevention of Diabetic Renal Failure

  • Gian Carlo Viberti
  • Carl Erik Mogensen
  • Philippe Passa
  • Rudy Bilous
  • Rugero Mangili

Abstract

Diabetic nephropathy is a major cause of premature death in diabetic patients, largely from uraemia and cardiovascular disease. Diabetic nephropathy develops in about 30% of people with insulin-dependent diabetes mellitus. The cumulative risk of nephropathy in people with non-insulin-dependent diabetes varies considerably with ethnic origin. It ranges from 25 % in individuals of European origin to around 50% in other ethnic groups such as the Afro-Caribbean, Asian Indians, and the Japanese. In the UK geographic areas at high density of these ethnic groups are likely to experience a higher incidence of renal disease. Asian Indians develop non-insulin-dependent diabetes more frequently and at a younger age than Europeans and Afro-Caribbean have a significantly higher frequency of arterial hypertension. All these factors are believed to contribute to their higher risk of kidney failure. Overall non-insulin-dependent diabetes is significantly more common than insulin-dependent diabetes and the number of non-insulin-dependent diabetic patients being accepted into renal replacement therapy (RRT) programmes is now equal, if not greater, than that of insulin-dependent diabetics. In Europe diabetes is the only increasing cause of end-stage renal failure and diabetic patients represent around 13 % of all patients receiving RRT. This percentage rises to approximately 30% in the United States of America. The cost of renal replacement therapy for end-stage diabetic renal failure in the United States was around $2 thousand million in 1991.

Keywords

Diabetic Nephropathy Renal Replacement Therapy Angiotensin Converting Enzyme Inhibitor Albumin Excretion Rate Diabetic Kidney Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Gian Carlo Viberti
  • Carl Erik Mogensen
  • Philippe Passa
  • Rudy Bilous
  • Rugero Mangili

There are no affiliations available

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