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Diabetic kidney disease
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Diabetic kidney disease, also called diabetic nephropathy, is the damage diabetes does to the kidney. It is the number one cause of end stage renal disease in developed countries, and it is recognized by two things together: persistent albuminuria, which is albumin, a blood protein, showing up in the urine, and a progressive decline in glomerular filtration, which is the measure of how much blood the kidney cleans.
The damage is in the glomerulus, the microscopic filter of the kidney. High glucose disrupts the signals inside the cells, drives the production of more matrix, the supporting material, and thickens the glomerular basement membrane, the sheet the filter rests on. The podocyte, a cell that is part of the filtration barrier, is also injured there, and when the podocyte is damaged protein leaks into the urine. The filter thickens and at the same time lets through what it used to hold back.
Under the microscope four things show up: an enlarged glomerulus, that thickened basement membrane, flattened podocyte foot processes and more mesangial matrix, the filler that supports the capillaries of the glomerulus.
In brief
Diabetic kidney disease is the leading cause of end stage renal disease in developed countries; it presents with persistent albuminuria and a decline in glomerular filtration.
Hyperglycemia disrupts cell signaling, increases matrix production and thickens the glomerular basement membrane; when the podocyte, part of the filter, is injured, proteinuria appears.
The filter thickens and at the same time lets through what it used to hold back.
Its lesions are glomerular hypertrophy, that thickening, flattening of the foot processes and expansion of the mesangial matrix.
Sources (1)
- National Center for Biotechnology Information, StatPearls PublishingDiabetic Nephropathy, StatPearlsPublished
This page explains the topic in general terms; it does not tell anyone what treatment to follow.
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