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Diabetic Nephropathy has Higher Mortality than Primary Nephropathy

2012-10-08 16:09

Primary nephropathy is kidney lesion that is caused by the organ itself other than other diseases such as primary glomerulonephritis, nephrotic syndrome, etc. If the kidney damages are caused by other diseases such as diabetes or hypertension, it is called secondary nephropathy.

Statistics have found that diabetic nephropathy has higher mortality than primary nephropathy though the population of diabetic nephropathy is less than that glomerulonephritis. And what are the reasons?

The basic pathological feature of diabetic nephropathy is the uniform hypertrophy of the glomerular basement membrane with the increased extracellular matrix of the mesangial cells. However, in the early stage, its symptoms are dormant and are easy to be neglected because patients are so focused on controlling blood sugar and they pay little attention to protecting kidneys.

1. Diabetes patients need to restrict the intake of carbohydrates. To ensure enough energy, they need to have more protein. This will cause excessive accumulation of phosphorus and metabolic wastes of protein such as urea nitrogen which will aggravate renal damages.

2. It is common that diabetes patients will have high blood pressure and this is due to metabolic disorder of lipid, atherosclerosis and many other reasons. Nearly all these patients have microalbuminuria in urine which indicates renal damages.

3. Long term high blood sugar can cause increase of capillary permeability and leakage of plasma protein which will damage the capillary basement membrane and result in glomerular sclerosis and renal interstitial fibrosis.

Usually diabetic nephropathy is detected when there are obvious clinic symptoms such as bubble urine, edema, vomiting, etc. Until this time the renal damages have been very severe. All these factors including metabolic disorders of lipid and sugar, hemodynamic change, hypertension, proteinuria, phenotypic conversion of the renal intrinsic cells will interact with each other and the illness conditions will fall into a vicious circle. That is why the renal damages are far more serious than in primary nephropathy.

If not detected and treated timely, the renal fibrosis will continue and finally lead to injuries and loss of kidney functions. Therefore it is very important for diabetes patients to have regular check of microalbuminuria which is an early and reliable indicator of renal damage.


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