Diagnosis and Management of Diabetic Nephropathy

Diabetic nephropathy (nephropatia diabetica), also known as Kimmelstiel-Wilson syndrome, or nodular diabetic glomerulosclerosis and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli. It is characterized by nephrotic syndrome and diffuse glomerulosclerosis. It is due to longstanding diabetes mellitus, and is a prime indication for dialysis in many Western countries.

Basic disorders: The damage that resulted in impaired glomerular renal function (albuminuria) for DM

Diagnosis

A. The principal complaint

• There is a history and complaints DM
• Weak
• Complaints of acute renal failure

B. The main sign

• Signs of chronic renal failure
• Pale
• hypertension

C. Laboratory tests

• Fasting blood sugar over 126 mg%
• Blood sugar two hours after fasting more than 200 mg%
• Micro-albuminuria (albumin excretion 20-200 mg / min or 30-300 mg/24 hours)
• Macroalbuminuria) albumin excretion more than 200 microg / min or> 300 mg/24 hours)
• HbAIC

D. Special Inspection

• Fundoscopy, there is diabetic retinopathy
• Renal biopsy: glomerular hypertrophy, glomerulo-sclerosis, hialinosis arteriole
• Ultrasound

Complication

• Hypertension
• Chronic renal failure
• Urinary tract infections
• Diabetic ketoacidosis

Management

• Rest
• Diet
• Medical
• Hemodialis
• Kidney transplantation

Prognosis
Most end up with kidney failure

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