A look at the prevention of nephropathy in diabetic patients.
Written in 2007; 3,656 words; 16 sources; MLA; $ 101.95
Paper Summary:
Nephropathy is a common complication of diabetes and is characterized by the development of proteinuria, culminating in end-stage renal disease with a particular high risk of cardiovascular morbidity and mortality. This paper looks at several pathologic processes that contribute to diabetic nephropathy, including glomerular hypertrophy, sclerosis and nephron loss and discusses how primary prevention includes early detection of diabetes, glycemic control, screening for microalbuminuria, control of hypertension and smoking cessation. The paper also looks at how key issues in secondary prevention are glycemic control, reduction of hypercholesterolemia, control of hypertension, smoking cessation, use of ACE inhibitors and possibly restriction of dietary protein.
From the Paper:
"Diabetic nephropathy is more prevalent among African Americans, Asians, and Native Americans than Caucasians (Zelmanovitz 2005). Moreover, among patients starting renal replacement therapy, the incidence of diabetic nephropathy doubled from 1991-2001, however the rate of increase has slowed down (Zelmanovitz 2005). The reason for the slow down is probably due to the adoption in clinical practice of several measures that contribute to the early diagnosis and prevention of diabetic nephropathy, which thereby decreases the progression of established renal disease (Zelmanovitz 2005). A ten-year follow-up revealed the risk of diabetic nephropathy was 29 times greater in patients with type 2 diabetes with UAE values > 10 (micro)g/min, and the same held true for patients with type 1 diabetes (Zelmanovitz 2005). This favors the concept that the risk associated with UAE is a continuum, as is the case with blood pressure levels (Zelmanovitz 2005). "
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