Post Date December, 02 2023
Diabetes nephropathy is a kidney injury caused by diabetes. It was previously expressed as DN (diabetic nephropathy). In 2007, the National Kidney Foundation (NKF) developed guidelines for the quality of life of kidney disease, or NKF/KDOQI for short. This guide recommends replacing DN with DKD (diabetical kidney disease).
In 2014, the American diabetes Association (ADA) and NKF reached a consensus that DKD (diabetic nephropathy) refers to chronic kidney disease caused by diabetes, mainly including glomerular filtration rate (GFR) below 60ml · min-1 · 1.73m2 or urinary albumin/creatinine ratio (ACR) above 30mg/g for more than three months. Diabetes glomerulopathy refers to glomerulopathy caused by diabetes confirmed by renal biopsy.
The diagnosis of diabetes nephropathy can be divided into pathological diagnosis and clinical diagnosis. Renal pathology is considered as the gold standard for diagnosis. Diabetes mainly causes glomerular lesions, which are manifested as mesangial hyperplasia, basement membrane thickening and K-W (Kimmelstiel Wilson) nodules, which are the main basis for pathological diagnosis. Diabetes can also cause renal tubulointerstitial and renal microvascular diseases, such as renal interstitial fibrosis, renal tubular atrophy, hyaline degeneration of the efferent artery or renal microvascular sclerosis. These changes can also be caused by other causes, and only serve as auxiliary indicators in diagnosis.
At present, the clinical diagnosis of diabetes nephropathy is based on urinary albumin and diabetes retinopathy. The early stage of diabetes nephropathy can be characterized by negative urinary albumin, which is not obvious and is easy to be ignored. However, there is still a lack of early detection indicators for diabetes nephropathy that are more reliable and sensitive than urinary microalbumin.
