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Renal function does not always predictably deteriorate in blind insulin-dependent diabetics with nephropathy
B D Edwards1, J McHale, C Newstead
1Department of Renal Medicine, Royal Infirmary, Manchester, UK.
American Journal of Nephrology
|January 1, 1994
Summary
Diabetic nephropathy outcomes are unpredictable despite risk factors like retinopathy and hypertension. Effective blood pressure management, not just ACE inhibitors, may preserve kidney function in these patients.
Area of Science:
- Nephrology
- Endocrinology
- Diabetology
Background:
- Presents two cases of insulin-dependent diabetes with severe retinopathy and nephrotic syndrome.
- Patients exhibited high-risk factors for progressive end-stage renal failure, including severe hypertension.
Observation:
- One patient experienced a gradual decline in creatinine clearance over 7 years.
- The other patient maintained normal plasma creatinine levels for 11 years.
Findings:
- Unexpectedly favorable renal outcomes were observed in both patients.
- Sustained normal blood pressure, achieved without prolonged angiotensin-converting enzyme inhibitor use, may be a key factor.
Implications:
- The prognosis of diabetic nephropathy requires reassessment due to effective antihypertensive therapies.
- Predicting diabetic kidney disease progression needs to account for diverse management strategies beyond ACE inhibitors.