Article Text
Abstract
Diabetic nephropathy is the leading cause of end stage renal disease worldwide and is associated with increased cardiovascular risk. The earliest clinical manifestation is of microalbuminuria. Tight blood glucose and blood pressure control reduce the risk of microalbuminuria. Once microalbuminuria is present, the rate of progression to end stage renal disease and of cardiovascular disease can be delayed by aggressive management of blood pressure, glucose, and lipids. Inhibition of the renin-angiotensin system is important to reduce intraglomerular pressure but other classes of antihypertensive agent may also be needed to gain adequate control of systemic blood pressure. Such measures can at least half the rate of progression of nephropathy and cardiovascular disease.
- ACE, angiotensin converting enzyme
- ATIIRB, angiotensin II receptor antagonist
- DCCT, Diabetes Control and Complications Trial
- HbA1c, glycated haemoglobin
- RRT, renal replacement therapy
- UKPDS, United Kingdom Prospective Diabetes Study
- diabetic nephropathy
- nephropathy
- microalbuminuria
- proteinuria
- diabetes
Statistics from Altmetric.com
Footnotes
Request Permissions
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.