Diabetic nephropathy overview

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Historical Perspective

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Differentiating Diabetic nephropathy from other Diseases

Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diabetic nephropathy (DN) is characterized by the presence of proteinuria or decreased renal function in patients with diabetes mellitus.[1][2][3]

Early Diabetic Nephropathy

The range of proteinuria in early DN is shown below[1][2][3]:

  • Males: Microalbuminuria in the range of 30-300 mg/24 hrs or a spot urinary albumin/creatinine ratio of 30-300 mg/g
  • Females: Microalbuminuria in the range of 30-300 mg/24 hrs or a spot urinary albumin/creatinine ratio of 20-200 mg/g

Overt Diabetic Nephropathy

Overt DN is defined according to the presence of proteinuria or according to renal function. The following ranges in overt DN are shown below[1][2][3]:

  • Proteinuria > 500 mg/24 hrs or albuminuria > 300 mg/24 hrs.
  • Estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Diabetic nephropathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Surgery

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

References

  1. 1.0 1.1 1.2 Mogensen CE, Christensen CK (1984). "Predicting diabetic nephropathy in insulin-dependent patients". N Engl J Med. 311 (2): 89–93. doi:10.1056/NEJM198407123110204. PMID 6738599.
  2. 2.0 2.1 2.2 Mogensen CE (1984). "Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes". N Engl J Med. 310 (6): 356–60. doi:10.1056/NEJM198402093100605. PMID 6690964.
  3. 3.0 3.1 3.2 Reutens AT, Atkins RC (2011). "Epidemiology of diabetic nephropathy". Contrib Nephrol. 170: 1–7. doi:10.1159/000324934. PMID 21659752.

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