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Diabetic nephropathy - Overview

Alternative Names

Kimmelstiel-Wilson disease; Diabetic glomerulosclerosis; Nephropathy - diabetic

Definition of Diabetic nephropathy:

Diabetic nephropathy is kidney disease or damage that results as a complication of diabetes.

Causes, incidence, and risk factors:

The exact cause of diabetic nephropathy is unknown, but it is believed that uncontrolled high blood sugar leads to the development of kidney damage, especially when high blood pressure is also present. In some cases, your genes or family history may also play a role. Not all persons with diabetes develop this condition.

Each kidney is made of hundreds of thousands of filtering units called nephrons. Each nephron has a cluster of tiny blood vessels called a glomerulus. Together these structures help remove waste from the body. Too much blood sugar can damage these structures, causing them to thicken and become scarred. Slowly, over time, more and more blood vessels are destroyed. The kidney structures begin to leak and protein (albumin) begins to pass into the urine.

Persons with diabetes who have the following risk factors are more likely to develop this condition:

African American, Hispanic, or American Indian origin
Family history of kidney disease or high blood pressure
Poor control of blood pressure
Poor control of blood sugars
Type 1 diabetes before age 20
Smoking

Diabetic nephropathy generally goes along with other diabetes complications including high blood pressure, retinopathy, and blood vessel changes.

Male urinary system

Pancreas and kidneys

Diabetic nephropathy

Reviewed last on: 5/20/2009
Reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Also reviewed by Deborah Wexler, MD, Assistant Professor of Medicine, Harvard Medical School, Endocrinologist, Massachusetts General Hospital.

References

American Diabetes Association (ADA). Standards of Medical Care in Diabetes—2009. Diabetes Care. January 2009; 32:S13-S61.

Inzucchi SE, Sherwin RS. Diabetes Mellitus. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 248.

American Diabetes Association (2004). Nephropathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care. 27(Suppl 1): S79–S83.

Parving H, Mauer M, Ritz E. Diabetic Nephropathy. In: Brenner BM. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 36.

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