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The kidney in diabetes

S M Mauer, M W Steffes, D M Brown

    The American Journal of Medicine
    |March 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Diabetic nephropathy stems from metabolic issues, not just high blood sugar. Kidney damage in diabetes shows distinct changes, with some potentially reversible.

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    Area of Science:

    • Nephrology
    • Endocrinology
    • Diabetology

    Background:

    • Diabetic nephropathy is a major complication of diabetes mellitus with significant social costs.
    • Metabolic derangements in diabetes, not solely hyperglycemia, are implicated in diabetic nephropathy.
    • Microvascular hemodynamic alterations likely contribute to glomerular pathology in diabetic kidneys.

    Purpose of the Study:

    • To explore the pathogenesis of diabetic nephropathy.
    • To investigate the roles of metabolic derangements and hemodynamic alterations in kidney complications of diabetes.
    • To differentiate the reversibility of structural changes in diabetic nephropathy.

    Main Methods:

    • Review of recent studies in humans and animals.
    • Analysis of the effects of metabolic derangements and microvascular hemodynamics.

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  • Examination of glomerular basement membrane and mesangial thickening.

    • Main Results:

    • Mesangial thickening in diabetic nephropathy is reversible upon curing the diabetic state in rats.
    • Glomerular basement membrane thickening is not reversible.
    • Disturbed vasoactive control mechanisms affecting angiotensin and prostaglandin metabolism may underlie hemodynamic alterations.

    Conclusions:

    • Diabetic nephropathy pathogenesis involves complex metabolic and hemodynamic factors.
    • Structural kidney damage in diabetes exhibits differential reversibility.
    • Advances in treatment for end-stage renal failure due to diabetes include transplantation and hemodialysis.