Opinion Article, J Nephrol Ren Dis Vol: 7 Issue: 3

Diabetic Nephropathy: The Renal Consequence of Diabetes Mellitus

Guifen Oklow^*

¹Ophthalmology Department, Biruni University Hospital, Istanbul, Turkey

*Corresponding Author: Guifen Oklow,
Ophthalmology Department, Biruni University Hospital, Istanbul, Turkey
E-mail: oklowfen@gmail.com

Received date: 28 August, 2023, Manuscript No. JNRD-23-117623;

Editor assigned date: 30 August, 2023, PreQC No. JNRD-23-117623 (PQ);

Reviewed date: 13 September, 2023, QC No. BMA-23-117623;

Revised date: 21 September, 2023, Manuscript No. JNRD-23-117623 (R);

Published date: 29 September, 2023, DOI: 10.4172/2576-3962.1000040

Citation: Ogunka-Nnoka CU, Ben-Piakor TE, Mepba HD, Ifeanacho MO (2020) Effect of Processing on Phytochemicals and Nutrient Composition of Tiger Nut (Cyperus esculentus L). J Food Nutr Disor 9:2. doi: 10.37532/jfnd.2020.9(2).271

Description

Diabetic nephropathy, also known as diabetic kidney disease, is a severe and often overlooked complication of diabetes mellitus. Diabetic nephropathy is a common and serious complication of diabetes mellitus, primarily affecting individuals with type 1 and type 2 diabetes. It is characterized by kidney damage due to long-term, uncontrolled high blood sugar levels. Diabetic nephropathy is primarily a microvascular complication of diabetes mellitus. It results from long-term exposure to high blood sugar levels and is associated with various pathological changes in the kidneys. Diabetic nephropathy results from prolonged exposure to high blood glucose levels, which can damage the small blood vessels (capillaries) in the glomeruli of the kidneys. This impairs the kidneys' ability to filter waste and excess fluids from the blood. The condition typically progresses through stages. In the early stage, there may be an increase in Glomerular Filtration Rate (GFR), but as the disease advances, the GFR declines, leading to reduced kidney function. Diabetic nephropathy often develops without noticeable symptoms in its early stages. As it progresses, individuals may experience symptoms like foamy urine, edema (swelling), high blood pressure, increased protein in the urine (proteinuria), and reduced urine output. Several factors can increase the risk of developing diabetic nephropathy, including poor blood sugar control, long duration of diabetes, high blood pressure, and a family history of kidney disease. Diabetic nephropathy is diagnosed through blood and urine tests, including serum creatinine, estimated Glomerular Filtration Rate (GFR), and Urinary Albumin- To-Creatinine Ratio (UACR). Kidney biopsies are rarely performed but may be needed in specific cases. Proper management of diabetes is essential for preventing or slowing the progression of diabetic nephropathy. This includes maintaining target blood sugar levels, controlling blood pressure, and managing lipid levels. Chronic hyperglycemia causes an increase in the size of glomeruli, the functional units of the kidney responsible for filtering blood. Glomerular hypertrophy can lead to increased Glomerular Filtration Rate (GFR), putting additional stress on the renal filtration system. In response to glomerular hypertrophy, there is an increased pressure within the glomerular capillaries. This can damage the delicate filtration membrane and lead to proteinuria, the presence of excess protein in the urine. The elevated pressure within the glomeruli can reduce blood flow to the kidneys, leading to renal hypoxia (insufficient oxygen supply). Hypoxia activates various molecular pathways, including the production of pro-inflammatory and pro-fibrotic factors. Chronic inflammation within the renal tissue is a key feature of diabetic nephropathy. It is driven by the activation of inflammatory pathways and the recruitment of immune cells to the kidney, contributing to tissue damage.

Clinical presentation

The clinical presentation of diabetic nephropathy is often insidious, and many individuals may remain asymptomatic until advanced stages of the disease. The hallmark sign of diabetic nephropathy is the presence of excess protein in the urine, primarily albumin. This condition is known as albuminuria. Initially, it may be microalbuminuria (30-300 mg/day), but it can progress to overt proteinuria (more than 300 mg/day). High blood pressure is a common comorbidity in individuals with diabetic nephropathy. It can both contribute to and result from kidney damage. Some patients may develop edema, particularly in the lower extremities, due to fluid retention. As the disease progresses, the Glomerular Filtration Rate (GFR) declines, leading to reduced kidney function. This is typically detected through blood tests that measure serum creatinine and estimate GFR. Kidney damage can impair the production of erythropoietin, a hormone necessary for red blood cell production, leading to anemia. Individuals with diabetic nephropathy have an increased risk of cardiovascular complications, including heart attacks and strokes.

Conclusion

Diabetic nephropathy is a significant and potentially devastating complication of diabetes mellitus, characterized by progressive kidney damage that can ultimately lead to end-stage renal disease. This condition arises from a complex interplay of factors, including chronic hyperglycemia, hypertension, genetic predisposition, and other risk factors. Understanding the pathophysiology of diabetic nephropathy is crucial for both healthcare professionals and individuals living with diabetes, as it can help guide early detection and management strategies.