الفهرس | Only 14 pages are availabe for public view |
Abstract Diabetic nephropathy is one of the most common complications affecting more than 30% of diabetic patients suffering for prolonged periods. Diabetic nephropathy is characterized by persistent albuminuria, decline in the glomerular filtration rate and elevated arterial blood pressure, which is confirmed on at least 2 occasions 3-6 months apart, based on the GFR decline and albumin excretion. Progression of DN has been classified into five different stages as suggested by K/DOQI guide lines. The two main risk factors for DN are hyperglycemia and arterial hypertension. Screening for diabetic nephropathy must be initiated at the time of diagnosis in patients with type 2 diabetes, since 7% of them already have microalbuminuria at that time. In type 1 diabetes, screening for microalbuminuria might be performed 1 year after diabetes diagnosis, especially in patients with poor metabolic control and after the onset of puberty. If microalbuminuria is absent, the screening must be repeated annually for both type 1 and 2 diabetic patients. The principles of prevention and treatment of DN are the same. It is important to define the DN stage that is the target of intervention. The aim of treatment is to intervene at arterial hypertension, hyperglycemia, smoking habit and probably dyslipidemia. |