Kidney Disease Part II - Diabetic Nephropathy (DN) Learning...

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Unformatted text preview: Diabetic Nephropathy (DN) Learning Objectives Describe the natural progression of DN Describe the effects of blood pressure lowering medications on urinary excretion of albumin Appreciate the anti proteinuric (renoprotective) effect of BP lowering drugs that is independent of their role in BP lowering. Know the clinical and dietary recommendations for slowing the progression of DN (and CKD) Diabetic Nephropathy (DN) The leading cause of end stage renal disease Affects 20 30% of individuals with diabetes mellitus Also known as diabetic kidney disease or DKD Onset 0 2 3 5 10 15 20 25 Stage 1: (onset time of diabetes diagnosis) High GFR and increased kidney size due to glomerular and tubular hypertrophy HTN likely present Stage 2: (onset 2 15 y) Clinically silent Basement membrane thickening and mesangial expansion Stage 3: Incipient Nephropathy (onset 10 15 years) Elevated BP Normalization of GFR Microalbuminuria (30 300 mg/24h) Stage 4: Overt Nephropathy (onset of 15 20 y) Decreased GFR Macroalbuminuria (>300 mg/24h) Stage 5: End Stage (onset 20 25 y) Kidney function loss is up to 3% per month Microalbuminuria = low levels of albumin in urine...
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This note was uploaded on 01/28/2012 for the course NS 441 taught by Professor Caudill during the Fall '11 term at Cornell University (Engineering School).

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Kidney Disease Part II - Diabetic Nephropathy (DN) Learning...

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