Diabetic Nephropathy is the most serious complication of Diabetes. It refers
to diabetic glomerulosclerosis. The incidence of Diabetic Nephropathy rise with
the disease course of Diabetes. In the early stage of Diabetic Nephropathy, the
volume of kidneys enlarges and glomerular filtration rate increases so the
glomeruli keep in hyperfiltration state. With the disease progression, the
patients will have microalbumin and intermittent protein in urine. Without
timely treatments, it will cause persistent proteinuria, edema, hypertension and
decreased glomerular filtration rate and then Renal Insufficiency and
Uremia.
Diabetic Nephropathy is prevalent among the patients with a Diabetes history
longer than 10 years. According to some researches, the pathogenesis of Diabetic
Nephropathy mainly includes the following points.
Abnormal renal hemodynamics
In the onset of Diabetic Nephropathy, abnormal renal hemodynamics is the
crucial cause and even the initiating factors.
(1) When blood sugar is high, the glomruli keeps in hypertransfusion state.
The pressure to the glomerular blood capillary wall increases. As a result, the
mesangial cells expand and the epithelial cells have feet-fusion. The glomerular
epithelial cells drop from basilar membrane.
(2) Under high pressure, the filtration of protein increases. The protein may
deposit in mesangial area or glomerular basilar membrane thus causing the
increasing of stroma, which can lead to focal segmental or diffusive
glomerulosclerosis.
High blood sugar
The onset of Diabetic Nephropathy is closely related to high blood sugar.
Good control of blood sugar can delay the disease progression obviously. High
blood sugar and end product of glycosylation can cause the proliferation of
mesangial cells and increasing of extracellular matrix as well as broadening of
mesangial area and so on.
Heredity
Most of the patients with Diabetes do not develop into Diabetic Nephropathy.
For some patients with Diabetes, even if they control their blood sugar very
well, they still can develop Diabetic Nephropathy. The incidence of Diabetic
Nephropathy presents familial aggregation. In the family with a history of
hypertension, the incidence of Diabetic Nephropathy is obviously higher than the
general population. In addition, the incidence of Diabetic Nephropathy also has
difference in the varying ethnicities.
Hypertension
Hypertension has no direct relation to the onset of Diabetic Nephropathy.
However, the primary hypertension or the increasing of blood pressure during the
disease process can accelerate the Diabetic Nephropathy to develop into Renal
Failure.
With increasing incidence of Diabetes, Diabetic Nephropathy has become an
important cause of Renal Failure. Therefore, the patients with Diabetes should
receive early treatments in time so as to prevent Diabetic Nephropathy from
developing into Renal Failure.