Diabetic Nephropathy

Question 1

what is diabetic kidney disease

Answer 1

characterised by albuminuria, low eGFR, in the setting of a long duration (>10 yrs) of diabetes

Question 2

what causes diabetic nephropathy

Answer 2

main causing factors are hypertension and hyperglycaemia which are manifestations of diabetes

inflammation, endothelial dysfunction, and oxidative stress are intertwined in a vicious cycle that leads to significant kidney damage and cardiovascular event

Question 3

risk factors for diabetic nephropathy

Answer 3

hypertension, hyperglycaemia, smoking, hyperlipidaemia, obesity

Question 4

presenting symptoms of diabetic nephropathy

Answer 4

hypertension, signs of retinopathy, oedema, numbness and pain in lower limbs

Question 5

investgations for DKD

Answer 5

urinalysis, urinary albumin to creatinine ratio, serum creatinine with GFR estimation, kidney ultrasound.

Question 6

signs of DKD

Answer 6

proteinuria, reduced eGFR in later stages, raised albuminuria, enlarged kidneys

Question 7

treatment of DKD

Answer 7

Glycaemic control, ACEi or ARB, nutrition, statins, nutrition,

dialysis/ K transplant

SMOKING CESSATION if relevant in ALL patients

Question 8

prognosis of DKD

Answer 8

DKD compared to CKD has worsening progression of proteinuria, eGFR and worse performance on dialysis