DIABETIC NEPHROPATHY MADRAS DIABETES RESEARCH FOUNDATION, Gopalapuram, Chennai DIRECTOR & DIABETOLOGIST Dr.Mohan’s DIABETES SPECIALITIES CENTRE Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Anna Nagar, Chennai Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Gopalapuram, Chennai Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Jubilee Hills, Hyderabad India Chennai (Formerly Madras) Hyderabad Dr.Ranjit Unnikrishnan I., M.D.,
DIABETIC NEPHROPATHY MADRAS DIABETES RESEARCH FOUNDATION, Gopalapuram, Chennai DIRECTOR & DIABETOLOGIST Dr.Mohan’s DIABETES SPECIALITIES CENTRE Dr. Mohan’s.
Jan 03, 2016
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DIABETIC NEPHROPATHY
MADRAS DIABETES RESEARCH FOUNDATION,
Gopalapuram, Chennai
DIRECTOR & DIABETOLOGIST
Dr.Mohan’s DIABETES SPECIALITIES CENTRE
Dr. Mohan’s DIABETES SPECIALITIES CENTRE,
Anna Nagar, Chennai
Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Gopalapuram, Chennai
Dr. Mohan’s DIABETES SPECIALITIES CENTRE, Jubilee Hills, Hyderabad
India
Chennai (Formerly Madras)Hyderabad
Dr.Ranjit Unnikrishnan I., M.D.,
DIABETIC NEPHROPATHY – MAGNITUDE OF THE PROBLEM
Most important cause of morbidity and mortality
in Type 1 diabetes – progression is faster
50% with clinical nephropathy reach ESRD by 10 years
75% with clinical nephropathy reach ESRD by 20 years
In Type 2 diabetes mellitus progression is slower –
20% reach ESRD
About 25 – 50% of all cases of ESRD is due to diabetes
? Racial factors ? Indians / Blacks more susceptible
High economic burden on society
NATURAL HISTORY OF NEPHROPATHY IN TYPE 1 DIABETES
Stage of hyper- filtration
Microalbumi- nuria
Macroalbumi- nuria
Azotemia (Renal failure)
End stage Renal disease
15 - 20 yrs 1 yrs 4 - 5 yrs
Normoalbumi-nuria
MICROALBUMINURIA AND DIABETIC NEPHROPATHY STAGES
Stages Designation Structural GFR UAE BP changes
Stage I Hyperfiltration Glomerular = 150 may N
or Hypertrophy Hypertrophy be
Stage II Normo BM 20% - N N
albuminuria thickness 30%
Stage III Microalbuminuria Further BM GFR 20 - 200
thickness g/min -3mm
of Hg
MICROALBUMINURIA AND DIABETIC NEPHROPATHY STAGES
Stages Designation Structural GFR UAE BP
changes
Stage Overt Clear and >200 Hyper-
IV Proteinuria Pronounced g/min tension
abnormalities Dipstick
positive
Stage End stage Glomerular >200
V Renal closure g/min Hyper-
Disease tension
PREVALENCE OF PROTEINURIACLINIC BASED STUDY ON 1848 TYPE 2 DIABETIC INDIVIDUALS
2.5
6.9
3.8
0 2 4 6 8
Microproteinuria
Macroproteinuria
Proteinuriawithout
retinopathy
PREVALENCE [%]
n=1848
Mohan V et al, Postgrad Med J. 2000;76:569-73.
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