diabetestalk.net

Diabetic Nephropathy Stages

Diabetic Nephropathy Overview

Diabetic Nephropathy Overview

Diabetic nephropathy is kidney disease that develops as a result of diabetes mellitus (DM). According to the American Diabetes Association, diabetes affects approximately 9.3 percent of the U.S. population (29.1 million people as of 2012). This disease damages many organs, including the eyes, nerves, blood vessels, heart, and kidneys. Diabetes is the most common cause of kidney failure in the United States and accounts for over one-third of all patients who are on dialysis. Diabetes mellitus is a disorder in which the body is unable to metabolize carbohydrates (e.g., food starches, sugars, cellulose) properly. The disease is characterized by excessive amounts of sugar in the blood (hyperglycemia) and urine; inadequate production and/or utilization of insulin; and by thirst, hunger, and loss of weight. Diabetics who require daily insulin shots to maintain life have insulin-dependent diabetes mellitus, or type 1 diabetes . In this type of diabetes, the pancreas secretes little or no insulin and the blood sugar level remains high, unless treated. Type 1 diabetes usually occurs in children and young adults, but it may occur at any age. In the past, this condition was also called juvenile onset diabetes. Onset of type 1 diabetes is abrupt. The patient becomes very sick and requires immediate insulin therapy. Approximately 3 million people in the United States have type 1 diabetes and each year, about 30, 000 people are diagnosed with the condition. Non-insulin-dependent diabetes, or type 2 diabetes , differs from type 1 in that the main problem is a peripheral resistance to the action of the insulin. DM 2 usually occurs in adults over the age of 40 who are overweight and have a family history of the disease. Some patients can manage their diabetes with weight loss and chang Continue reading >>

5 Stages Of Diabetic Nephropathy

5 Stages Of Diabetic Nephropathy

Diabetics should not only pay attention to blood sugar level, but also check up your microalbuminuria regularly. About 30%-40% diabetics will develop to Diabetic Nephropathy , and then uremia. But there are still some patients who have not realized the possible crisis. Now lets have a quick look at the 5 stages of Diabetic Nephropathy. According to the Mogensen stages, Diabetic Nephropathy is classified into five stages. some patients may have elevated blood pressure swelling , high blood pressure , and high blood cholesterol level In stage 1, it is reversible. After treatment, you can get well. In stage 2, structure of glomeruli has changed, which need comprehensive treatment to recover. In stage 3, it is also called early stage of Diabetic Nephropathy. Your blood pressure may increase slightly, some glomeruli are damaged, and it becomes more difficult to reverse the disease. In stage 4, its characteristic is massive proteinuria, swelling and high blood pressure. The possibility of recovery decreases. In stage 5, it is ESRD, in which you have declined kidney function. Most patients can not get well and you have to start conventional dialysis. With the development of medical science, some scholars think that Diabetic Nephropathy should not be classified according to proteinuria, but GFR. But no matter which stage you are in, you should take measures timely to prevent further kidney damage. In stage 1, you can check up GFR, which can help you find out Diabetic Nephropathy in early stage. In stage 2, urine microalbumin increases when you do some sports. It can be detected when you do microalbuminuria test. In stage 3, urine microalbumin begins to increase persistently, which can be detected easily. And it is possible for you to reverse the disease with timely treatment. Continue reading >>

Diabetic Nephropathy

Diabetic Nephropathy

Definition and Causes Diabetic nephropathy (DN) is typically defined by macroalbuminuria—that is, a urinary albumin excretion of more than 300 mg in a 24-hour collection—or macroalbuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate (GFR). Clinically, diabetic nephropathy is characterized by a progressive increase in proteinuria and decline in GFR, hypertension, and a high risk of cardiovascular morbidity and mortality. Prevalence and Risk Factors Diabetes has become the primary cause of end-stage renal disease (ESRD) in the United States, and the incidence of type 2 diabetes mellitus continues to grow in the United States and worldwide. Approximately 44% of new patients entering dialysis in the United States are diabetics. Early diagnosis of diabetes and early intervention are critical in preventing the normal progression to renal failure seen in many type 1 and a significant percentage of type 2 diabetics. In the United States, approximately 20.8 million people, or 7.0% of the population, are estimated to have diabetes, with a growing incidence. Roughly one third of this population, 6.2 million, is estimated to be undiagnosed with type 2 diabetes. The prevalence of diabetes is higher in certain racial and ethnic groups, affecting approximately 13% of African Americans, 9.5% of Hispanics, and 15% of Native Americans, primarily with type 2 diabetes.1, 2 Approximately 20% to 30% of all diabetics will develop evidence of nephropathy, although a higher percentage of type 1 patients progress to ESRD. Pathophysiology and Natural History The common progression from microalbuminuria to overt nephropathy has led many to consider microalbuminuria to define early or incipient Continue reading >>

Diabetic Nephropathy (kidney Disease)

Diabetic Nephropathy (kidney Disease)

Diabetic nephropathy refers to diabetic kidney disease (nehpro=kidneys, pathy=disease). In 2011, diabetes caused nearly 44% of kidney failure cases. This makes diabetic kidney disease the Number One complication of diabetes; one that is likely to affect almost every diabetic to some extent. In nearly half the cases of kidney disease, it could lead to kidney failure as well. Diabetes and Kidney Damage The kidneys filter nearly 200 quarts of our blood every day. Diabetes is a disease of excess sugar in our blood. Read these two sentences together and the link between diabetes and kidneys becomes obvious! Every single day of our lives, the kidneys perform these functions: Remove waste from our body (in the form of urine) Retain whatever proteins, vitamins and other nutrients we can still use Balance the fluids in the body Help maintain proper blood pressure by managing potassium and calcium levels Keep bones healthy Help make red blood cells. Diabetes damages the kidneys and the urinary system in three main ways: Damage to blood vessels in the kidneys: Too much sugar damages the filters in the kidneys Damage to nerves: Fine nerves in the hands, feet, etc. are corroded by the extra sugar in the blood Damage to the urinary tract: Nerves run from our bladder to our brain and let us know when the bladder is full and we need to go. Damage to these nerves could mean we don’t react when our bladder is full. Result: extra pressure on the kidneys. Retained urine can also allow urinary tract infections to grow and migrate back to the kidneys. Diabetes damage to blood vessels inside kidneys: The filtering units of the kidneys are called glomeruli (sing. – glomerulus). They have tiny blood vessels that are easily clogged and damaged by excess sugar in our blood. Damage to these ve Continue reading >>

Diabetic Nephropathy - Symptoms

Diabetic Nephropathy - Symptoms

There are no symptoms in the early stages of diabetic nephropathy. If you have kidney damage, you may have small amounts of protein leaking into your urine (albuminuria). Normally, protein is not found in urine except during periods of high fever , strenuous exercise , pregnancy , or infection. Not everyone with diabetes will develop diabetic nephropathy. In people with type 1 diabetes , diabetic nephropathy is more likely to develop 5 to 10 years or more after the onset of diabetes . People with type 2 diabetes may find out that they already have a small amount of protein in the urine at the time diabetes is diagnosed, because they may have had diabetes for several years. As diabetic nephropathy progresses, your kidneys cannot do their job as well. They cannot clear toxins or drugs from your body as well. And they cannot balance the chemicals in your blood very well. You may: Have higher cholesterol and triglyceride levels. You may have symptoms if your nephropathy gets worse. These symptoms include: Swelling ( edema ), first in the feet and legs and later throughout your body. Continue reading >>

A New Classification Of Diabetic Nephropathy 2014: A Report From Joint Committee On Diabetic Nephropathy

A New Classification Of Diabetic Nephropathy 2014: A Report From Joint Committee On Diabetic Nephropathy

A new Classification of Diabetic Nephropathy 2014: a report from Joint Committee on Diabetic Nephropathy 1Department of Medicine, Asahikawa Medical University, Hokkaido, Japan 2Jikei University School of Medicine, Tokyo, Japan 3Kanazawa Medical University, Ishikawa, Japan 4Tokyo Women's Medical University, Tokyo, Japan 6Okayama University Hospital, Okayama, Japan 7St. Marianna University School of Medicine, Kanagawa, Japan 10Tohoku University Hospital, Miyagi, Japan 11Osaka City University Graduate School of Medicine, Osaka, Japan 13Wakayama Medical University, Wakayama, Japan 15Kagawa Nutrition University, Saitama, Japan 16Kawasaki Medical School Hospital, Hiroshima, Japan 17Kyoto University Hospital, Kyoto, Japan * Correspondence Masakazu Haneda, Tel.: +81-166-68-2454, Fax: +81-166-68-2459, E-mail address: [email protected] Joint Committee on Diabetic Nephropathy members are in Appendix 2. Author information Article notes Copyright and License information Disclaimer Received 2014 Nov 12; Revised 2014 Nov 17; Accepted 2014 Nov 17. Copyright 2014 Japan Diabetes Society, Japanese Society of Nephrology, Japanese Society for Dialysis Therapy, and Japan Society of Metabolism and Clinical Nutrition. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and Wiley Publishing Asia Pty Ltd This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. This article has been cited by other articles in PMC. The Joint Committee on Diabetic Nephropathy has revised its Classification of Diabetic Nephropathy (Classifi Continue reading >>

Diabetic Nephropathy Symptoms

Diabetic Nephropathy Symptoms

Diabetic nephropathy is the damage caused to kidneys due to diabetes mellitus. Usually, the condition develops after a diabetes duration of about 10 years. Around one fourth of all people who have had diabetes for more than 10 years are at risk of diabetic nephropathy. Diabetic nephropathy is not typically characterized by symptom onset, meaning that most individuals who develop it are unaware of the condition until it has already caused considerable damage. Screening diabetic patients for kidney damage is therefore important in reducing the risk of long-term kidney damage and its associated problems. Some of the features of diabetic kidney disease that may eventually manifest include: Edema or swelling of the ankles, feet, lower legs or hands due to water retention. Urine that is foamy or frothy in appearance due to excessive protein being excreted in the urine. This is most commonly seen in the first urine of the day. Weight gain due to fluid retention and edema Stages of development of diabetic nephropathy Research provides insights into mechanisms governing healthy longevity During stage 1, the rate of kidney filtration is increased. The glomerular filtration rate (GFR) in the kidney is increased and the organ may increase in size. However, urine albumin levels and blood pressure may be only mildly raised or normal. At this early stage of nephropathy, there is no pathological damage and the condition is usually reversible. During stage 2, there is structural damage of the glomeruli and microalbuminuria starts to occur. The GFR is higher than normal. Stage 3 disease is termed early stage renal disease. The albumin excretion rate is continuously raised and may exceed 200 g/min. Blood levels of creatinine are raised and blood pressure may also be high. This stage of d Continue reading >>

Pathologic Classification Of Diabetic Nephropathy

Pathologic Classification Of Diabetic Nephropathy

Pathologic Classification of Diabetic Nephropathy *Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands; Department of Pathology, University of Erlangen-Nuernberg, Erlangen, Germany; Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California; Department of Histopathology, Hammersmith Hospital, London, United Kingdom; Department of Pathology, University of Maryland, Baltimore, Maryland; Renal Immunopathology Center, San Carlo Borromeo Hospital, Milan, Italy; **Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Pathology, Sendai-Shaho Hospital, Sendai City, Japan; Department of Pathology, Hpital Necker, Universit Ren Descartes, Paris, France; Department of Medicine, Columbia University, New York, New York; and Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York Dr. Antien L. Mooyaart, Department of Pathology, Building 1, L1-Q, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. Phone: 0031715266574; Fax: 0031715266952; E-mail: a.l.mooyaart{at}lumc.nl Although pathologic classifications exist for several renal diseases, including IgA nephropathy, focal segmental glomerulosclerosis, and lupus nephritis, a uniform classification for diabetic nephropathy is lacking. Our aim, commissioned by the Research Committee of the Renal Pathology Society, was to develop a consensus classification combining type1 and type 2 diabetic nephropathies. Such a classification should discriminate lesions by various degrees of severity that would be easy to use internationally in clinical practice. We divide diabetic nephropathy into four hierarchical glomerular lesions with a separate evaluation for degrees of interstitial and Continue reading >>

Diabetic Nephropathy

Diabetic Nephropathy

Diabetic nephropathy (diabetic kidney disease) (DN)[1] is the chronic loss of kidney function occurring in those with diabetes mellitus. It is a serious complication, affecting around one-quarter of adult diabetics in the United States. It usually is slowly progressive over years. [2] Pathophysiologic abnormalities in DN begin with long-standing poorly controlled blood glucose levels. This is followed by multiple changes in the filtration units of the kidneys, the nephrons. (There are normally about 3/4-1 1/2 million nephrons in each adult kidney).[3] Initially, there is constriction of the efferent arterioles and dilation of afferent arterioles, with resulting glomerular capillary hypertension and hyperfiltration; this gradually changes to hypofiltration over time.[4] Concurrently, there are changes within the glomerulus itself: these include a thickening of the basement membrane, a widening of the slit membranes of the podocytes, an increase in the number of mesangial cells, and an increase in mesangial matrix. This matrix invades the glomerular capillaries and produces deposits called Kimmelstiel-Wilson nodules. The mesangial cells and matrix can progressively expand and consume the entire glomerulus, shutting off filtration.[5] The status of DN may be monitored by measuring two values: the amount of protein in the urine - proteinuria; and a blood test called the serum creatinine. The amount of the proteinuria is a reflection of the degree of damage to any still-functioning glomeruli. The value of the serum creatinine can be used to calculate the estimated glomerular filtration rate (eGFR), which reflects the percentage of glomeruli which are no longer filtering the blood.[citation needed] Treatment with an angiotensin converting enzyme inhibitor (ACEI) or angiotensi Continue reading >>

Diabetic Nephropathy

Diabetic Nephropathy

Overview Diabetic nephropathy is a serious kidney-related complication of type 1 diabetes and type 2 diabetes. It is also called diabetic kidney disease. Up to 40 percent of people with diabetes eventually develop kidney disease. Diabetic nephropathy affects the ability of your kidneys to do their usual work of removing waste products and extra fluid from your body. The best way to prevent or delay diabetic nephropathy is by maintaining a healthy lifestyle and treating your diabetes and high blood pressure. Over many years, the condition slowly damages your kidneys' delicate filtering system. Early treatment may prevent or slow disease progression and reduce the chance of complications. Your kidney disease may progress to kidney failure, also called end-stage kidney disease. Kidney failure is a life-threatening condition. At this stage your treatment options are dialysis or a kidney transplant. Symptoms In the early stages of diabetic nephropathy, you may not notice any signs or symptoms. In later stages, the signs and symptoms include: Worsening blood pressure control Protein in the urine Swelling of feet, ankles, hands or eyes Increased need to urinate Less need for insulin or diabetes medicine Confusion or difficulty concentrating Loss of appetite Nausea and vomiting Persistent itching Fatigue When to see a doctor Make an appointment with your doctor if you have any signs or symptoms of kidney disease. If you have diabetes, visit your doctor yearly for a urine test that detects protein. This helps determine how well the kidneys are functioning. Causes Diabetic nephropathy results when diabetes damages blood vessels and other cells in your kidneys. How the kidneys work Your kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your Continue reading >>

Diabetic Nephropathy (kidney Disease)

Diabetic Nephropathy (kidney Disease)

What is diabetic nephropathy? Nephropathy means your kidneys are not working well. The final stage of nephropathy is called kidney failure, end-stage renal disease, or ESRD. Diabetes, both type 1 and type 2, is the most common cause of kidney disease. Type 1 is more likely to lead to ESRD. There are 5 stages of diabetic nephropathy. The final stage is ESRD. Progress from one stage to the next can take many years. What causes diabetic nephropathy? Both high blood pressure and high blood sugar damage the kidneys. As kidney disease gets worse, physical changes in the kidneys often lead to increased blood pressure. Uncontrolled high blood pressure can speed the progress toward ESRD. High blood sugar related to diabetes damages the kidney in several different ways. Mainly, it damages the blood vessels that filter the blood to make urine. What are the symptoms of diabetic nephropathy? Over years, as kidney disease develops, small amounts of the blood protein albumin begin to show in your urine. This first stage of chronic kidney disease is called moderately increased albuminuria or microalbuminuria. The kidneys are still able to filter waste during this stage. As the disease worsens larger amounts of albumin leak into the urine. This stage may be called severely increased albuminuria or macroalbuminuria. As the amount increases, the kidneys can’t cleanse the blood as well. Wastes are left in the blood. Blood pressure often rises as well. Overall, kidney damage rarely happens in the first 10 years of diabetes. Kidney failure usually happens 15 to 25 years after the first symptoms of diabetes. If you have had diabetes for more than 25 years without any signs of kidney failure, your risk of developing it decreases. How is diabetic nephropathy diagnosed? If you have diabetes, i Continue reading >>

What Is Diabetic Nephropathy?

What Is Diabetic Nephropathy?

Diabetic nephropathy is the damage caused to the kidneys by diabetes mellitus. Around 50% of individuals with type 1 diabetes will develop nephropathy within 10 years of having the disease and around 20% of those with type 2 disease will develop it within 20 years. The persistently high blood sugar that occurs in diabetes can eventually cause damage to various organs including the kidneys, eyes and heart. Diabetic nephropathy usually has a silent onset, meaning it may not be detected until much of the kidney is damaged. Research provides insights into mechanisms governing healthy longevity Some of the features of diabetic nephropathy include: Raised level of the protein albumin in the urine. Damaged kidneys may let large molecules such as albumin pass though into the urine, causing urine levels of albumin to rise. Raised blood levels of creatinine. Creatinine is normally filtered out from the body by the kidneys but if the kidneys are damaged, the blood levels of creatinine may be raised. There may be other organ damage caused by diabetes such as heart disease or diabetic retinopathy (eye damage). Without treatment, diabetic nephropathy may eventually leads to end stage renal disease. In the initial stages of disease, diabetic nephropathy does not cause pathological damage to the kidneys and is reversible. If the condition progresses, the kidneys will start to become damaged and the gromerular filtration rate will decrease. The extent of kidney damage can range from mild and symptomless, as in stage 2 disease, through to end stage renal disease which is characterized by a significantly lowered filtration rate causing a build up of waste products in the blood. Individuals with disease that is this advanced eventually require dialysis or a kidney transplant to stay alive Continue reading >>

Five Stages Of Diabetic Nephropathy | Understand Diabetic Nephropathy

Five Stages Of Diabetic Nephropathy | Understand Diabetic Nephropathy

Diabetic Nephropathy is the most common chronic complication of diabetes. Some patients can lose their ability to work Diabetic nephropathy has been divided into five stages. Diabetic Nephropathy is the most common chronic complication of diabetes, and it can worsen your illness and lead to metabolic disorder. It can even cause kidney failure if the treatment is not prompt. In such cases, some patients can lose their ability to work while it proves fatal for some others. Diabetic nephropathy has been divided into five stages, each having different recommendations for treatment. Stage 1: Renal or kidney functions are changed in this stage. The kidney increases in size, and it is accompanied by high filtration and priming rate. Patients need to strictly control their glucose in this stage. Stage 2: The structure of kidney is changed for worse and patients pass protein in their urine after intense physical activity. They are required to rest as much as possible in this stage. Stage 3: This stage comes after patients have suffered from diabetes for 5 to 15 years. Around 30 to 40 percent of patients would have advanced condition of proteinuria at this stage and their renal functions begin to decline. Stage 4: This stage is known as Clinical Diabetic Nephropathy whose characteristic is large amount of proteinuria, more than 3.5 grams daily, along with Edema and high blood pressure. Patients in this stage suffer from severe form of edema and their condition is not sensitive to diuretics. Stage 5: It is called uremia and patients condition is critical. They need to undergo dialysis and kidney transplant to sustain their life. The patients are always worried about their condition in this stage of the disease. The decision to take dialysis or not is always facing them even thoug Continue reading >>

Diabetic Nephropathy

Diabetic Nephropathy

Diabetic nephropathy is a type of progressive kidney disease that may occur in people who have diabetes. It affects people with type 1 and type 2 diabetes, and risk increases with the duration of the disease and other risk factors like high blood pressure and a family history of kidney disease. Over 40 percent of cases of kidney failure are caused by diabetes, and it’s estimated that approximately 180,000 people are living with kidney failure caused by complications of diabetes. Diabetes is also the most common cause of end-stage renal disease (ESRD). ESRD is the fifth and final stage of diabetic nephropathy. Diabetic nephropathy progresses slowly. With early treatment, you can slow or even stop the progression of the disease. Not everyone who develops diabetic nephropathy will progress to kidney failure or ESRD, and having diabetes does not mean you will develop diabetic nephropathy. The early stages of kidney damage often do not cause noticeable symptoms. You may not experience any symptoms until you are in the late stages of chronic kidney disease. Symptoms of ESRD may include: fatigue general overall unwell feeling loss of appetite headache itchy and dry skin nausea or vomiting swelling of your arms and legs Each of your kidneys has about one million nephrons. Nephrons are small structures that filter waste from your blood. Diabetes can cause the nephrons to thicken and scar, which make them less able to filter waste and remove fluid from the body. This causes them to leak a type of protein called albumin into your urine. Albumin can be measured to help diagnose and determine the progression of diabetic nephropathy. The exact reason this occurs in people with diabetes is unknown, but high blood sugar levels and high blood pressure are thought to contribute to diab Continue reading >>

Diabetic Nephropathy - Kidney Disease

Diabetic Nephropathy - Kidney Disease

Tweet Kidney disease amongst diabetics is commonly called diabetic nephropathy. Statistically, around 40% of people with diabetes develop nephropathy but it is possible to prevent or delay through control of both blood glucose and blood pressure levels. Diabetes affects the arteries of the body and as the kidneys filter blood from many arteries, kidney problems are a particular risk for people with diabetes. What is diabetic nephropathy? Nephropathy is a general term for the deterioration of proper functioning in the kidneys. At an advanced level, this is called end-stage renal disease or ESRD. ESRD often stems from diabetes, with diabetes causing just under half of all cases. Diabetic nephropathy can affect people with both type 1 and type 2 diabetes. Diabetic nephropathy is divided into five stages of deterioration, with the final one being ESRD. It commonly takes over 20 years for patients to reach stage 5. Symptoms of kidney disease The symptoms of diabetic nephropathy tend to become apparent once the condition has reached the later stages. Typically the following symptoms may start to be noticed around stage four of its progression: Swelling of the ankles, feet, lower legs or hands caused by retention of water Darker urine, caused by blood in the urine Becoming short of breath, when climbing the stairs for instance Tiredness as a result of a lack of oxygen in the blood Nausea or vomiting To help catch nephropathy before the later stages develop, people with diabetes should be screened for kidney complications once a year. The screening test involves a simple urine sample which is tested to detect whether protein is present in the urine. Read more on kidney disease screening What are the causes of diabetic nephropathy? Statistics show that development of kidney dise Continue reading >>

More in diabetes