Diabetic Nephropathy

Question 1

Albuminuria predicts…

Answer 1

CV mortality

Question 2

What is the pathogenesis of diabetic nephropathy?

Answer 2

Hyperglycemia direct damages the glomerulus
Glucose also results in the creation of ROS which cause damage
Creation of an inflammatory state that promotes atherosclerosis and impacts renal hemodynamics
ECM accumulation, GBM thickening, glomerulosclerosis

Question 3

Effect of ACEi/ARBs on glomerulus

Answer 3

Reduce vasoconstriction and glomerular pressure (act on the efferent arteriole)
This will transiently decrease the GFR but in the long term it is a good thing and is protective

Question 4

SGLT2 inhibitors

Answer 4

Block the sodium glucose linked cotransporter in the PCT
Reduce the amount of Na and glucose that is reabsorbed into the blood
UTI is a side effect
Positive impacts on CV outcomes
Slow progression of diabetic nephropathy

Question 5

In diabetes is BP or sugar control more important?

Answer 5

BP control!

Question 6

5 lifestyle interventions that decrease BP

Answer 6

DASH diet
Limit Na intake
Reduce body weight
Regular physical activity
Low risk alcohol consumption