Skip to main content

Diabetic Nephropathy: An Overview

  • Protocol
  • First Online:
Diabetic Nephropathy

Part of the book series: Methods in Molecular Biology ((MIMB,volume 2067))

Abstract

Diabetic nephropathy (DN) is one of the most feared diabetic chronic microvascular complications and the major cause of end-stage renal disease (ESRD). The classical presentation of DN is characterized by hyperfiltration and albuminuria in the early phases which is then followed by a progressive renal function decline. The presentation of diabetic kidney disease (DKD) can vary especially in patients with T2DM where concomitant presence of other glomerular/tubular pathologies and severe peripheral vascular disease can become important confounders. All-cause mortality in individuals with DKD is approximately 30 times higher than that in diabetic patients without nephropathy and a great majority of patients with DKD will die from cardiovascular disease before they reach ESRD. The management of metabolic and hemodynamic perturbations for the prevention and for the delay of progression of DKD is very important. DKD is a global challenge and a significant social and economic burden; research should aim at developing new ideas to tackle this devastating condition.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Protocol
USD 49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Collaboration NCDRF (2016) Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 387(10027):1513–1530

    Article  Google Scholar 

  2. Federation ID (2018) IDF diabetes atlas, Brussels

    Google Scholar 

  3. Organization WH (2018) Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2016. Switzerland, Geneva

    Google Scholar 

  4. American Diabetes A (2016) 2. Classification and diagnosis of diabetes. Diabetes Care 39(Suppl 1):S13–S22

    Google Scholar 

  5. Ahlqvist E, Storm P, Karajamaki A, Martinell M, Dorkhan M, Carlsson A et al (2018) Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. Lancet Diabetes Endocrinol 6(5):361–369

    Article  Google Scholar 

  6. Hovind P, Rossing P, Tarnow L, Smidt UM, Parving HH (2001) Progression of diabetic nephropathy. Kidney Int 59(2):702–709

    Article  CAS  Google Scholar 

  7. Gnudi L, Gentile G, Ruggenenti P (2016) The patient with diabetes mellitus. In: Turner N, Lamiere N, Goldsmith DJ, Wineearls CG, Himmelfarb J, Remuzzi G (eds) Oxford textbook of clinical nephrology, vol 2. Oxford University Press, Oxford, pp 1199–1247

    Google Scholar 

  8. Young BA, Maynard C, Boyko EJ (2003) Racial differences in diabetic nephropathy, cardiovascular disease, and mortality in a national population of veterans. Diabetes Care 26(8):2392–2399

    Article  Google Scholar 

  9. Gnudi L, Thomas SM, Viberti G (2007) Mechanical forces in diabetic kidney disease: a trigger for impaired glucose metabolism. J Am Soc Nephrol 18(8):2226–2232

    Article  CAS  Google Scholar 

  10. Saran R, Robinson B, Abbott KC, Agodoa LY, Albertus P, Ayanian J et al (2017) US Renal Data System 2016 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis 69(3 Suppl 1):A7–A8

    Article  Google Scholar 

  11. Gross JL, de Azevedo MJ, Silveiro SP, Canani LH, Caramori ML, Zelmanovitz T (2005) Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care 28(1):164–176

    Article  Google Scholar 

  12. Haraldsson B, Nystrom J, Deen WM (2008) Properties of the glomerular barrier and mechanisms of proteinuria. Physiol Rev 88(2):451–487

    Article  CAS  Google Scholar 

  13. Gnudi L, Coward RJ, Long DA (2016) Diabetic nephropathy: perspective on novel molecular mechanisms. Trends Endocrinol Metab 27(11):820–830

    Article  CAS  Google Scholar 

  14. Deckert T, Feldt-Rasmussen B, Borch-Johnsen K, Jensen T, Kofoed-Enevoldsen A (1989) Albuminuria reflects widespread vascular damage. The Steno hypothesis. Diabetologia 32(4):219–226

    Article  CAS  Google Scholar 

  15. Berhane AM, Weil EJ, Knowler WC, Nelson RG, Hanson RL (2011) Albuminuria and estimated glomerular filtration rate as predictors of diabetic end-stage renal disease and death. Clin J Am Soc Nephrol 6(10):2444–2451

    Article  Google Scholar 

  16. de Boer IH, Sun W, Cleary PA, Lachin JM, Molitch ME, Steffes MW et al (2011) Intensive diabetes therapy and glomerular filtration rate in type 1 diabetes. N Engl J Med 365(25):2366–2376

    Article  Google Scholar 

  17. UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352(9131):837–853

    Article  Google Scholar 

  18. UK Prospective Diabetes Study Group (1998) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 317(7160):703–713

    Article  Google Scholar 

  19. Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB et al (2001) Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 345(12):851–860

    Article  CAS  Google Scholar 

  20. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH et al (2001) Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 345(12):861–869

    Article  CAS  Google Scholar 

  21. Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. (2019) Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 13;380(24):2295–2306

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luigi Gnudi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Science+Business Media, LLC, part of Springer Nature

About this protocol

Check for updates. Verify currency and authenticity via CrossMark

Cite this protocol

Sagoo, M.K., Gnudi, L. (2020). Diabetic Nephropathy: An Overview. In: Gnudi, L., Long, D. (eds) Diabetic Nephropathy. Methods in Molecular Biology, vol 2067. Humana, New York, NY. https://doi.org/10.1007/978-1-4939-9841-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-9841-8_1

  • Published:

  • Publisher Name: Humana, New York, NY

  • Print ISBN: 978-1-4939-9840-1

  • Online ISBN: 978-1-4939-9841-8

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics