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[Classification of the main kidney diseases in diabetes mellitus]
Insights
This study proposes new terms for kidney disease in diabetes, focusing on vascular issues. It introduces classifications like diabetic microangionephropathy and diabetic angionephropathy for better understanding and diagnosis.
Area of Science:
- Nephrology
- Diabetology
- Vascular Medicine
Context:
- Current classifications for kidney disease in diabetes mellitus often overlook the primary vascular origins of renal complications.
- Existing terminology like 'diabetic glomerulosclerosis' and 'diabetic nephropathy' inadequately represents the underlying vascular pathology.
Purpose:
- To propose a revised classification system for kidney affections in diabetes mellitus, emphasizing vascular genesis.
- To introduce precise terminology reflecting small vessel (microangionephropathy), large vessel (macroangiography), and combined renal vessel (angionephropathy) involvement.
- To integrate pyelonephritis into the classification due to its high prevalence in diabetic patients.
Summary:
- A new classification for diabetic kidney disease is presented, highlighting vascular origins.
- Key terms include diabetic microangionephropathy, macroangiography, and diabetic angionephropathy.
- Diabetic nephropathy is redefined as a complex condition encompassing angionephropathy and pyelonephritis.
- Diabetic microangionephropathy is categorized into four distinct clinico-laboratory stages.
- Emphasis is placed on the diagnostic accessibility of these proposed classifications in healthcare settings.
Impact:
- Facilitates a more accurate understanding and diagnosis of kidney complications in diabetes mellitus.
- Enables earlier and more precise identification of vascular versus infectious kidney pathologies.
- Aims to improve patient management and outcomes through refined diagnostic criteria and staging.
Abstract:
In the suggested classification of affections of the kidneys in diabetes mellitus the main attention is paid to the vascular genesis of the appearing disturbances. The terms used formerly ("diabetic glomerulosclerosis", "diabetic nephropathy") failed to reflect the primary affections of the vessels. The following new terms are suggested: "diabetic microangionephropathy" (affection of the small vessels), "macroangiography" (affection of the large vessels), "diabetic angionephropathy" (complex affection of the renal vessels). "Pyelonephritis" (acute and chronic) was also introduced into the classification due to its exceedingly frequent occurrence in diabetes. The term "diabetic nephropathy" is suggested for complex affection including diabetic angionephropathy and pyelonephritis. Diabetic microangionephropathy should be divided into four clinico-laboratory stages; their characteristics are presented. Particular attention was paid to the accessibility of their diagnosis in medical institutions.