Diabetic nephropathy : improving prognosis
Author
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 13, Issue 3 (30 Jun. 2002), pp.281-310, 30 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2002-06-30
Country of Publication
Saudi Arabia
No. of Pages
30
Main Subjects
Topics
Abstract EN
Diabetes is the disorder most often linked with development of end-stage renal disease (ESRD) in the USA, Europe, South America, Japan, India, and Africa.
Kidney disease is as likely to develop in long-duration non-insulin dependent diabetes (type 2) as in insulin-dependent diabetes mellitus (type 1).
Nephropathy in diabetes, if sub-optimally managed, follows a predictable course starting with micro albuminuria through proteinuria, azotemia and culminating in ESRD.
The rate of renal functional decline in diabetic nephropathy is slowed by normalization of hypertensive blood pressure, establishment of euglycemia, and a reduced dietary protein intake.
When compared with other causes of ESRD, the diabetic patient sustains greater mortality and morbidity due to associated systemic disorders especially coronary artery and cerebrovascular disease.
A functioning kidney transplant provides the uremic diabetic patient better survival with superior rehabilitation than does either continuous ambulatory peritoneal dialysis (CAPD) or maintenance hemodialysis.
There are no reports, however, of prospective controlled studies of dialysis versus kidney transplantation in diabetic patients whose therapy was assigned randomly.
Survival in treating ESRD of diabetes is continuously improving.
This progress reflects multiple small advances in understanding of the pathogenesis of extrarenal micro- and micro vasculopathy coupled with safer immunosuppression.
Combined pancreas and kidney transplantation has so far been performed for a minority (<10%) of diabetic ESRD patients and has offered cure of the diabetes and full rehabilitation.
No matter which ESRD therapy has been elected, optimal rehabilitation in diabetic ESRD patients requires that effort be devoted to recognition and management of co-morbid conditions.
American Psychological Association (APA)
Friedman, Eli A.. 2002. Diabetic nephropathy : improving prognosis. Saudi Journal of Kidney Diseases and Transplantation،Vol. 13, no. 3, pp.281-310.
https://search.emarefa.net/detail/BIM-61241
Modern Language Association (MLA)
Friedman, Eli A.. Diabetic nephropathy : improving prognosis. Saudi Journal of Kidney Diseases and Transplantation Vol. 13, no. 3 (Jun. 2002), pp.281-310.
https://search.emarefa.net/detail/BIM-61241
American Medical Association (AMA)
Friedman, Eli A.. Diabetic nephropathy : improving prognosis. Saudi Journal of Kidney Diseases and Transplantation. 2002. Vol. 13, no. 3, pp.281-310.
https://search.emarefa.net/detail/BIM-61241
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 303-310
Record ID
BIM-61241