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Diabetic nephropathy
Definition:
Diabetic nephropathy is a complication of diabetes. If you have this condition, your kidney loses its ability to function properly. The condition is characterized by high protein levels in the urine. Alternative Names:
Kimmelstiel-Wilson disease; Diabetic glomerulosclerosis; Diabetic kidney disease Text Continues Below
Causes, incidence, and risk factors:
Each kidney is made of more than a million units called nephrons. Each nephron has a tuft of blood vessels called a glomerulus. The glomerulus filters blood and forms urine, which drains down into collecting ducts to the ureter. The earliest detectable change in the course of diabetic nephropathy is a thickening in the glomerulus. At this stage, the kidney may start allowing more albumin (protein) than normal in the urine, and this can be detected by sensitive tests for albumin. This stage is called "microabuminuria" (micro refers to the small amounts of albumin). As diabetic nephropathy progresses, increasing numbers of glomeruli are destroyed. Now the amounts of albumin being excreted in the urine increases, and may be detected by ordinary urinalysis techniques. At this stage, a kidney biopsy clearly shows diabetic nephropathy. Protein may appear in the urine for 5 to 10 years before other symptoms develop. High blood pressure often accompanies diabetic nephropathy. Over time, the kidney's ability to function starts to decline. Diabetic nephropathy may eventually lead to chronic kidney failure. The disorder continues to progress toward end-stage kidney disease, usually within 2 to 6 years after the appearance of high protein in the urine (proteinuria).
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