Introduction of diabetic nephropathy

出自KMU Wiki

• The most common cause of incident ESRD and the 2nd commonest cause of prevalent ESRD in Taiwan
• Prevalence
  • 40% in type 1 and 2 DM
  • Because type 2 DM is much more common than type 1 DM, most diabetic nephropathy patients have type 2 DM
• Importance of hyperglycemia in DN
  • DCCT (Diabetes Control and Complications Trial)
    • Type 1 DM
    • NEJM 1993;329:977. The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
  • UKPDS (UK Prospective Diabetes Study)
    • Lancet 1998;352:837. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
    • Type 2 DM
  • Intensive glycemic control prevents microangiopathy in newly diagnosed DM, but effects on macroangiopathy (cardiovascular diseases and atherosclerosis) are less certain
• Other risk factors of DN
  • Hypertension (HT), proteinuria, smoking, hyperlipidemia, genetics (family history, renin-angiotensin gene polymorphism)