Diabetic Nephropathy

Question 1

What is diabetic nephropathy the most common cause of in the UK

Answer 1

Glomerular pathology and CKD

Question 2

How does diabetic nephropathy cause glomerular pathology:

Answer 2

Chronic high levels of glucose passing through the glomerulus causes scarring

Causing Glomerular sclerosis

Question 3

What is a key feature of diabetic nephropathy and what causes it?

Answer 3

Proteinuria - key feature

Due to damage to the glomerulus allowing protein to be filtered from the blood -> urine

Question 4

What screening tests should be done regularly for patients with diabetes? (for diabetic nephropathy)

Answer 4

ACR (albumin:creatinine ratio)

U&Es

Question 5

Management of patients with diabetic nephropathy

Answer 5

Treatment is by optimising blood pressure control and blood glucose control

ACE inhibitors are drug of choice for BP control in diabetics
- they should be used on all patients with diabetic nephropathy even if they have a normal BP