Stages of Diabetic Nephropathy in T1DM

Question 1

Describe what happens in Stage 1 and 2 of diabetic nephropathy

Answer 1

1. hyperfiltration
   => increase in GFR
2. persistently elevated GFR
   AKA “silent” or “Latent” phase

Question 2

What begins to develop in stage 3 diabetic nephropathy

Answer 2

microalbuminuria
- albumin excretion of 30 - 300 mg/day
- dipstick negative for protein

Question 3

Symptoms/signs of stage 4 diabetic nephropathy

Answer 3

• proteinuria (albumin excretion > 300 mg/day, dipstick positive)
• hypertension is present in most patients

Question 4

Histology findings in stage 4 diabetic nephropathy

Answer 4

• diffuse glomerulosclerosis
• focal glomerulosclerosis (Kimmelstiel-Wilson nodules)

Question 5

What level has the GFR reached in stage 5 diabetic nephropathy?

Answer 5

<10ml/min
- RRT needed

Question 6

Describe the progression of diabetic nephropathy in patients with T2DM

Answer 6

• similar stages but in a different timescale
• shorter “latent” phase
  => progress quickly to the later stages