Skip to main content
SpringerLink
Log in
Book cover

Therapy of Renal Diseases and Related Disorders pp 533–542Cite as

Diabetic Nephropathy

  • Chapter

Abstract

Diabetes mellitus may be complicated by diverse renal disorders (Table 1) ranging from an increased susceptibility to serious intrarenal infections such as renal carbuncle, to progressive microvasculopathy and macrovasculopathy of renal arteries, culminating in renal insufficiency. Throughout the industrialized world, the glomerulopathy termed diabetic nephropathy is the third most common cause of treatment for end-stage renal disease (ESRD). Uremia associated with diabetes in the United States accounts for the largest defined subset of federally supported patients with ESRD; 12.2% of Medicare-funded uremic patients who are currently treated by maintenance hemodialysis or renal transplantation are diabetic. While “glomerulonephritis” (28.4%) and “hypertension” (17.4%) are reported more frequently in the American registry (1), these diagnoses are usually employed as synonyms for unexplained kidney failure associated with small kidneys in the majority of patients so labeled.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sugimoto T, Rosansky SJ: The incidence of treated end stage renal disease in the Eastern United States: 1973–1979. Am J Public Health 74:14–16, 1984.

    PubMed  CAS  Google Scholar 

  2. Harris MI, Hadden WC, Knowler WC, Bennett PH: Prevalence of diabetes and impaired glucose tolerance and plasma glucosel levels in U.S. population aged 20–74yr. Diabetes 36:523–534, 1987.

    Article  PubMed  CAS  Google Scholar 

  3. Sievers ML, Fisher JR: Diabetes in America. National Diabetes Data Group, National Institutes of Health, Washington DC, 1985.

    Google Scholar 

  4. Sutherland DER, Fryd DS, Simmons RL, Kjellstrand CM, Ramsay RC, Goetz FC, Mauer SM, Najarian JS: Long-term diabetic renal transplants. In: EA Friedman, L’Esperance, eds, Diabetic Renal Retinal Syndrome. Grune & Stratton, New York, pp 353–371, 1980.

    Google Scholar 

  5. Seiden RF, Skoskiewicz MJ, Russel PS, Goodman HM: Regulation of insulin-gene expression. Implications for gene therapy. N Engl J Med 317:1067–1076, 1987.

    Article  Google Scholar 

  6. Ginsberg-Fellner F, Rubinstein P, Notkins AL: Ten-year longitudinal study of children at high risk of insulin dependent diabetes (letter). N Engl J Med 317:1352–1353, 1987.

    Article  PubMed  CAS  Google Scholar 

  7. Colman PG, Eisenbarth GS: Immunotherapy in type I diabetes. Approaches to prevention and treatment. Postgrad Med 81:146–155, 1987.

    PubMed  CAS  Google Scholar 

  8. Palestine AG, Austin HA, Balow JE, Antonovych TT, Sabnis SG, Preuss HG, Nussenblatt RB: Renal histopathologic alterations in patients treated with cyclosporine for uveitis. N Engl J Med 314:1293–1298, 1986.

    Article  PubMed  CAS  Google Scholar 

  9. Chomette G, Auriol M, Beaufils H, Rottemberg J, Cabrol C: Morphology of cyclosporine nephrotoxicity in human heart transplant recipients. J Heart Transplant 5:273–278, 1986.

    PubMed  CAS  Google Scholar 

  10. Kobayashi T, Sugimoto T, Itoh T, Kosaha K, Tanaka T, Suwa S, Sato K, Tsuji K: The prevalence of islet cell antibodies in Japanese insulin-dependent and non-insulin-dependent diabetic patients studied by indirect immunofluorescence and by a new method. Diabetes 35:335–340, 1986.

    Article  PubMed  CAS  Google Scholar 

  11. Viberti GC, Macintosh D, Bilous RW, Pickup JC, Keen H: Proteinuria in diabetes mellitus: Role of spontaneous and experimental variation of glycemia. Kidney Int 21:714–720, 1982.

    Article  PubMed  CAS  Google Scholar 

  12. Jerums G, Cooper ME, Seeman E, Murray RML, McNeil JJ: Spectrum of proteinuria in Type I and Type II diabetes. Diabetes Care 10:419–427, 1987.

    Article  PubMed  CAS  Google Scholar 

  13. Taguma U, Kimamoto U, Futaki G, Hitoshi U, Hiromichi M, Makoto I, Hisashi T, Hiroshi S, Yasuhiko S: Effect of Captopril on heavy proteinuria in azotemic diabetics. N Engl J Med 313:1617–20, 1985.

    Article  PubMed  CAS  Google Scholar 

  14. Stephen RL, Maxwell JG, Kablitz C, Jacobson SC, Hanover B, Tyler F: Proc Eur Dial Transpl Assoc 20:692–699, 1983.

    CAS  Google Scholar 

  15. Sampietro T, Bertuglia S, Colantuoni A, Bionda A, Lenzi S, Donato: Increased permeability of hamster microcirculation to glycosylated albumin. Lancet 2:994–996, 1987.

    Article  PubMed  CAS  Google Scholar 

  16. Marre M, Leblanc H, Leobardo S, Thanh-Tarn G, Menard J, Passa P: Converting enzyme inhibition and kidney function in normotensive diabetic patients with persistent microalbuminuria. Br Med J 294:1448–1452, 1987.

    Article  CAS  Google Scholar 

  17. Cohen D, Dodds R, Viberti G: Effect of protein restriction in insulin dependent diabetes at risk of nephropathy. Br Med J [Clin Res] 294:795–798, 1987.

    Article  CAS  Google Scholar 

  18. Evanoff GV, Thompson CS, Brown J, Weinman EJ: The effect of dietary protein restriction on the progression of diabetic nephropathy. A 12-month follow-up. Arch Int Med 147:492–495, 1987.

    Article  CAS  Google Scholar 

  19. Raskin P, Rosenstock J: Aldose reductase inhibitors and diabetic complications. Am J Med 83:298–306, 1987.

    Article  PubMed  CAS  Google Scholar 

  20. Hommel E, Mathiesen E, Arnold-Larsen S, Edsberg B, Olsen UB, Parving HH: Effects of indomethacin on kidney function in type 1 (insulin-dependent) diabetic patients with nephropathy. Diabetologia 30:78–81, 1987.

    PubMed  CAS  Google Scholar 

  21. Ferrari E, Fioravanti M, Patti AL, Viola C, Solerte SB: Effects of long-term treatment (4 years) with pentoxifylline on haemorheological changes and vascular complications in diabetic patients. Pharmatherapeutica 5:26–39, 1987.

    PubMed  CAS  Google Scholar 

  22. Nath KA. Platelet participation in renal diseases. The Kidney (Published by National Kidney Foundation) 20:1–6, 1987.

    Google Scholar 

  23. Friedman EA, Peterson CM (eds): Diabetic Nephropathy. Martinus Nijhoff, Boston, 1986.

    Google Scholar 

  24. Kimmelstiel P, Wilson C: Intercapillary lesions in the glomeruli of the kidney. Am J Pathol 12:83–98, 1936.

    PubMed  CAS  Google Scholar 

  25. Mauer SM, Chavers BM: A comparsion of kidney disease in type I and type II diabetes. Adv Exp Med Biol 189:299–303, 1985.

    PubMed  CAS  Google Scholar 

  26. Lowder GM, Perri NA, Friedman EA: Demographics, diabetes type, and degree of rehabilitation in diabetic patients on maintenance hemodialysis in Brooklyn. J Diabetic Complications, in press, 1988.

    Google Scholar 

  27. The DCCT Research Group: The diabetes control and complications trial (DCCT). Design and methodologic considerations for the feasibility phase. Diabetes 35:530–45, 1986.

    Article  Google Scholar 

  28. Mauer SM, Brown DM, Steffes MW: Studies on the reversibility of kidney changes in experimental diabetes in the rat. Acta Endocrinol (Suppl) 242:29–30, 1981.

    CAS  Google Scholar 

  29. Zatz R, Brenner BM: Pathogenesis of diabetic microangiopathy. The hemodynamic view. Am J Med 80:443–453, 1986.

    Article  PubMed  CAS  Google Scholar 

  30. Anderson S, Meyer TW, Rennke HG, Brenner BM: Control of glomerular hypertension limits glomerular injury in rats with reduced renal mass. J Clin Invest 76:612–619, 1985.

    Article  PubMed  CAS  Google Scholar 

  31. Finco DR, Crowell WA, Barsanti JA: Effects of three diets on dogs with induced chronic renal failure. Am J Vet Res 46:646–653, 1985.

    PubMed  CAS  Google Scholar 

  32. Bosch JP, Lauer A, Glabman S: Short-term protein loading in assessment of patients with renal disease. Am J Med 77:873–879, 1984.

    Article  PubMed  CAS  Google Scholar 

  33. Zatz R, Dunn BR, Meyer TW, Anderson S, Rennke HG, Brenner BM: Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. J Clin Invest 77:1925–1930, 1986.

    Article  PubMed  CAS  Google Scholar 

  34. Ciavarella A, DiMizio G, Stefoni S, Borgnino LC, Vannini P: Reduced albuminuria after dietary protein restriction in insulin-dependent diabetic patients with clinical nephropathy. Diabetes Care 10:407–413, 1987.

    Article  PubMed  CAS  Google Scholar 

  35. Kaysen GA, Gambertoglio J, Jimenez I, Jones H, Hutchison FN: Effect of dietary protein intake on albumin homeostasis in nephrotic patients. Kidney Int 29:572–577, 1986.

    Article  PubMed  CAS  Google Scholar 

  36. Mogensen CE: Progression of nephropathy in long-term diabetics with proteinuria and effect of initial antihypertensive treatment. Scand J Clin Lab Invest 36:383–388, 1976.

    Article  PubMed  CAS  Google Scholar 

  37. Passa P, LeBlanc H, Marre M: Effects of enalapril in insulin-dependent diabetic subjects with mild to moderate uncomplicated hypertension. Diabetes Care 10:200–204, 1987.

    Article  PubMed  CAS  Google Scholar 

  38. Rutherford WE, Blondin J, Miller JP, Greenwalt AS, Vavra JD, Chronic progressive renal disease: Rate of change of serum creatinine concentration. Kidney Int 11:62–70, 1977.

    Article  PubMed  CAS  Google Scholar 

  39. Flynn CT, Shadur CA: A comparsion of continuous ambulatory peritoneal dialysis in diabetic and nondiabetic patients. Am J Kidney Dis 1:15–23, 1981.

    PubMed  CAS  Google Scholar 

  40. Engle GL: A life setting conducive to illness. The giving-up-given-up complex. Bull Menninger Clin 32:355–365, 1968.

    Google Scholar 

  41. Lindblad AS, Nolph KD, Novak JW, Friedman EA: A survey of the NIH CAPD registry population with end-stage renal disease attributed to diabetic nephropathy. J Diabetic Complications, in press, 1988.

    Google Scholar 

  42. Burlingham WJ, Grailer A, Sparks-Mackety EM, Sondel PM, Sollinger HW: Improved renal alograft survival following donor-specific transfusions. II. In vitro correlates of early (DST-type) rejection episodes. Transplantation 43:41–44, 1987.

    Article  PubMed  CAS  Google Scholar 

  43. Terasaki PI, Himaya NS, Cecka M, Cicciarelli J, Cook DJ, Ito T, Iwaki Y, Mickey MR, Takiff H, Tiwari JL, Toyotome A. Overview. In: Terasaki PI, ed, Clinical Transplants 1986. UCLA Tissue Typing Laboratory, Los Angeles, pp 367–398, 1986.

    Google Scholar 

  44. Sutherland DER, Morrow CE, Fryd DS, Ferguson R, Simmons RL, Najarian JS: Improved patient and primary renal allograft survival in uremic diabetic recipients. Transplantation 34:319–325, 1982.

    Article  PubMed  CAS  Google Scholar 

  45. Sollinger HW, Stratta RJ, Kalayoglu M, Beizer FO: The University of Wisconsin experience in pancreas transplantation. Transplant Proceed 19 (Suppl 4):48–54, 1987.

    CAS  Google Scholar 

  46. Sutherland DE, Moudry KC: Pancreas Transplant Registry: History and analysis of cases 1966 to October 1986. Pancreas 2:473–488, 1987.

    Article  PubMed  CAS  Google Scholar 

  47. Slapak M: Triple and quadruple immunosuppressive therapy in organ transplantation. Lancet 2:958–960, 1987.

    Article  PubMed  CAS  Google Scholar 

  48. Mauer SM, Steffes MW, Connett J, Najarian JS, Sutherland DE, Barbosa J: The development of lesions in the glomerular basement membrane and mesangium after transplantation of normal kidneys to diabetic patients. Diabetes 32:948–52, 1983.

    Article  PubMed  CAS  Google Scholar 

  49. Maryniak RK, Mendoza N, Clyne D, Balakrishnan K, Weiss MA: Recurrence of diabetic nodular glomerulosclerosis in a renal transplant. Transplantation 39:35–38, 1985.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Eli A. Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Baylor College of Medicine, The Methodist Hospital, Houston, Texas, USA

    Wadi N. Suki

  2. Division of Nephrology, University of Southern California, Los Angeles, California, USA

    Shaul G. Massry

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Kluwer Academic Publishers

About this chapter

Cite this chapter

Friedman, E.A. (1991). Diabetic Nephropathy. In: Suki, W.N., Massry, S.G. (eds) Therapy of Renal Diseases and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0689-4_34

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-0689-4_34

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8027-9

  • Online ISBN: 978-1-4613-0689-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation