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Related Concept Videos

Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Type II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

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Related Experiment Video

Updated: May 27, 2026

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
10:31

Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice

Published on: May 2, 2025

Early renal function decline in type 2 diabetes.

Meda E Pavkov1, William C Knowler, Kevin V Lemley

  • 1Centers for Disease Control and Prevention, 4770 Buford Hwy, NE MS-K10, Atlanta, GA 30341-3724, USA. mpavkov@cdc.gov

Clinical Journal of the American Society of Nephrology : CJASN
|November 15, 2011
PubMed
Summary
This summary is machine-generated.

In type 2 diabetes, early renal function decline (RFD) predicts end-stage renal disease (ESRD), but this association is mainly driven by progression to macroalbuminuria. Monitoring GFR and albuminuria is crucial for predicting kidney disease progression.

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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
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Area of Science:

  • Nephrology
  • Endocrinology
  • Diabetology

Background:

  • Early decline in glomerular filtration rate (GFR) may indicate progressive kidney disease in type 1 diabetes.
  • The predictive value of early GFR decline for kidney disease progression in type 2 diabetes remains uncertain.

Purpose of the Study:

  • To investigate the predictive value of early renal function decline (RFD) for end-stage renal disease (ESRD) in individuals with type 2 diabetes.
  • To determine the role of albuminuria in the association between RFD and ESRD.

Main Methods:

  • A longitudinal study involving 195 Pima Indians with type 2 diabetes.
  • Serial GFR measurements over approximately 4 years to define RFD (GFR loss ≥3.3%/yr).
  • Follow-up for up to 17.8 years for ESRD onset, death, or study end.

Main Results:

  • RFD prevalence varied by albuminuria status: 32% in normal, 42% in microalbuminuria, and 74% in macroalbuminuria.
  • 10-year cumulative incidence of ESRD was 41% in those with RFD versus 15% without (P<0.001).
  • RFD was associated with a 4.78-fold increased ESRD hazard rate, which was attenuated after adjusting for albuminuria.

Conclusions:

  • In type 2 diabetes, GFR loss often precedes macroalbuminuria.
  • The predictive value of GFR decline for ESRD is strongly dependent on the progression to macroalbuminuria.
  • Albuminuria status is a critical factor in assessing the risk of ESRD in type 2 diabetes patients with declining GFR.