Diabetic Nephropathy: Hemodynamic Basis and Implications for Disease Management
Authors: Robert H. Noth, Andrzej S. Krolewski, George A. Kaysen, Timothy W. Meyer, Morris Schambelan
Journal: Annals of Internal Medicine (1989)

Davis Conference15 May 1989Diabetic Nephropathy: Hemodynamic Basis and Implications for Disease ManagementRobert H. Noth, MD, Andrzej S. Krolewski, MD, PhD, George A. Kaysen, MD, PhD, Timothy W. Meyer, MD, Morris Schambelan, MDRobert H. Noth, MD, Andrzej S. Krolewski, MD, PhD, George A. Kaysen, MD, PhD, Timothy W. Meyer, MD, Morris Schambelan, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-10-795 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNew evidence shows that systemic and intrarenal hemodynamic abnormalities are major factors in the initiation and progression of diabetic nephropathy. Genetic predisposition to elevated systemic blood pressure may contribute to its development. Glomerular vasodilation and hyperfiltration, mediated in part by prostaglandins, may play a role in glomerular damage early in the course of diabetes, but clinical studies are limited. The development of more sensitive assays for albuminuria now allows early diagnosis of incipient nephropathy in the "microalbuminuria" phase. Treatment during this phase with antihypertensive agents, including angiotensin-converting enzyme inhibitors, or with dietary protein restriction, can decrease the degree of albuminuria,...References1. Abuelo J. Proteinuria: diagnostic principles and procedures. Ann Intern Med. 1983;98:186-91. LinkGoogle Scholar2. KussmanGoldsteinGleason MHR. The clinical course of diabetic nephropathy. JAMA. 1976;236:1861-3. CrossrefMedlineGoogle Scholar3. FabreBalantDayerFoxVernet JLPHA. The kidney in maturity onset diabetes mellitus: a clinical study of 510 patients. Kidney Int. 1982;21:730-8. CrossrefMedlineGoogle Scholar4. Friedman E. Diabetic nephropathy: strategies in prevention and management. Kidney Int. 1982;21:780-91. CrossrefMedlineGoogle Scholar5. Mogensen C. 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Author, Article, and Disclosure InformationAffiliations: From the Interdepartmental Dean's Conference arranged by the Department of Medicine, University of California, Davis, School of Medicine, Davis, California, and the Veterans Administration Medical Center, Martinez, California. Michael G. Geokas, MD, PhD, is permanent chairman and organizer of these conferences.Authors who wish to cite a section of the conference and specifically indicate its author can use this example for the form of the reference:Krolewski AS. The natural history of diabetic nephropathy in type I diabetes and the role of hypertension, pp 795-798. In: Noth RH. Diabetic Nephropathy: Hemodynamic Basis and Implications for Disease Management. Ann Intern Med. 1989;110:795-813. 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