renal essay - diabetic kidney disease

Question 1

What other complications of diabetes have a high prevalence in patients with DKD?

Answer 1

Microvascular complications - neuropathy and retinopathy in 80% of patients

Question 2

What metabolic changes from diabetes and hyperglycaemia damage the kidneys?

Answer 2

Advanced glycation end products (AGEs), oxidative stress, inflammation damage nephrons via fibrinogenesis

Question 3

How do haemodynamic changes in diabetes damage the kidneys?

Answer 3

An increase in angiotensin II increases systemic and intraglomerular pressure causing damage to the glomerulus

Question 4

How does glomerulosclerosis occur in DKD?

Answer 4

Relative dilation of the afferent arteriole increases plasma flow and glomerular hydrostatic pressure. It will beome damaged and fibrinogenesis will occur, particularly via AGEs which thicken the basement membrane and cause inflammation and cellular proliferation. Hyperfiltration will occur, leading to microalbuminuria followed by frank proteinuria.

Question 5

What is the histological morphology of the glomerulus in DKD?

Answer 5

Hypetrophied, mesanagial expansion and compression of capillary lumens, hyaline deposits, thickened basement mebranes, podocyte detachment, nodular mesangial sclerosis

Question 6

What is the histological morphology of the tubules and interstitium in DKD?

Answer 6

tubular atrophy, thickened tubular basement membrane, interstitial fibrosis

Question 7

What is the histological morphology of the renal vessels in DKD?

Answer 7

hyalinosis of afferent and efferent arterioles, intimal sclerosis