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Query: UMLS:C0011881 (diabetic nephropathy)
 10,836 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this paper we studied the effects of a low-protein, low-phosphorus supplemented diet in 8 type I diabetics with 'overt' diabetic nephropathy and mild or severe renal insufficiency. We examined the following parameters: the rate of decline of creatinine clearance, the urinary protein loss, the total serum protein, the daily insulin requirement, the serum fasting glucose, the pattern of serum lipids (serum total cholesterol, HDL cholesterol and serum triglycerides), the mean blood pressure and body weight. The rate of decline of creatinine clearance decreased monthly from 1.48 +/- 0.20 ml/min during a previous 15.6-month period of unrestricted protein diet (UPD), to 0.13 +/- 0.3 ml/min during the 11.4 months on the supplemented diet (SD). The mean blood pressure did not differ during UPD (130.9 +/- 7.0 mmHg) and during SD (128.1 +/- 1.6 mmHg). Urinary protein loss significantly decreased on SD, and total serum protein increased. The daily insulin requirement and the serum fasting glucose levels significantly decreased on SD. Serum cholesterol was lower during SD than during UPD, while serum HDL cholesterol and serum triglycerides were not significantly modified. In some patients the body weight decreased on SD as a consequence of the disappearance of edema. In conclusion, on the basis of these preliminary observations, the SD slows the progression of renal failure and seems to exert several beneficial and no unwanted side-effects in renal failure of type I diabetics.
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PMID:Effects of a low-phosphorus, low-protein diet supplemented with essential amino acids and keto analogues on 'overt' diabetic nephropathy. 343 63

Blacks who are at a greater risk of renal failure than whites also experience a greater prevalence of diabetic nephropathy. Preliminary data suggest that black uremic diabetics fare less well than whites following a kidney transplant. Planning treatment for the diabetic with progressive renal insufficiency requires an allowance for the high probability that coincident multisystem disease will develop. We now understand that the mysterious concept of unmanageable "brittle diabetes" was a myth derived from flawed interaction between patient and physician. By establishing a team approach, the patient is protected from the stress of having conflicting treatment protocols prescribed by physicians concerned with only one organ or system. Black diabetics who may often have less family income than whites may require more intensive support from social workers and diabetes educators to understand and cope with the burden of kidney failure. The majority of uremic diabetics, both black and white, can survive at least the first 3 years of dialysis or renal transplantation with preserved sight and intact limbs. It may be anticipated that the proportion of nephropathic diabetics who attain rehabilitation will continue to increase.
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PMID:Race and diabetic nephropathy. 355 Dec 57

Because the metabolic changes in normal pregnancy are diabetogenic, pregnancy imposes a severe stress on the metabolic milieu of diabetic patients. Moreover, some patients with long-standing diabetes have vascular complications, including renal insufficiency and hypertension, that represent separate risk factors for optimal fetal development. During the past two to three decades, maternal mortality has been eliminated and perinatal deaths have been reduced in all classes of diabetic patients, including those with diabetic nephropathy, to a level approaching that of normal pregnant women. Fetal and neonatal morbidity have also been reduced, although rates of congenital abnormalities and respiratory disease syndrome remain high. In patients with significant vascular complications, such as nephropathy and retinopathy, pregnancy evidently does not alter the natural course of these complications. With meticulous metabolic control and fetal surveillance, however, women with diabetic nephropathy without severe renal insufficiency or severe hypertension can anticipate a pregnancy outcome similar to that of other insulin-dependent diabetic patients.
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PMID:Effect of diabetic nephropathy on pregnancy. 355 7

9 consecutive cases of Legionnaires' disease are presented, all of which involved either a pathological urinary sediment or acute renal insufficiency. Diabetic glomerular sclerosis and terminal septic shock in one patient accounted per se for the urinary findings and terminal oliguric renal failure. In the remaining 8 patients the renal abnormalities are interpreted as manifestations of Legionnaires' disease: these were acute renal insufficiency in 6, requiring dialysis treatment in 4, proteinuria in 7, hematuria in 5, leukocyturia in 5 and cylindruria in 3 patients. One patient died of pneumonia and one patient, without Legionella-related renal involvement, of septic shock. Renal histology of 5 patients showed acute interstitial nephritis in one and diffuse sclerosing interstitial nephritis in a second patient, whose biopsy was obtained after 3 months' hemodialysis treatment. In 3 patients renal biopsy findings were explained by preexisting renal pathology, i.e. diabetic nephropathy, chronic transplant rejection and shock kidney respectively. Renal failure requiring hemodialysis and urinary abnormalities were largely reversible.
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PMID:[Renal involvement in Legionnaires' disease]. 381 99

34 patients with analgesic nephropathy (AN) were investigated by real-time ultrasonography. In 11 out of 14 patients on maintenance dialysis and in 16 out of 20 patients with renal insufficiency calcified renal papillae were documented surrounding the central sinus in a typical garland pattern. Moreover, by surveying a group of patients with renal insufficiency of unknown origin, AN was assumed in 10 patients and was then confirmed by a hitherto unknown history of analgesic abuse as well as by laboratory findings. In 37 patients radiologic or autopsy data were additionally available. A close correlation to the scanning pattern was found in 31 of these patients. In 30 healthy volunteers and 56 patients with renal insufficiency due to chronic glomerulonephritis (n = 24) or diabetic nephropathy (n = 32) calcified renal papillae were found only in 1 case. 5 out of 20 patients on maintenance dialysis due to other diseases than AN showed renal calcifications forming an approximate garland arrangement. In these patients sonography may therefore indicate AN only in very characteristic cases. We believe that renal papillary calcifications surrounding the central sinus in a garland pattern may indicate AN in most cases and thus may be helpful in establishing the diagnosis of AN.
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PMID:Ultrasonic findings in analgesic nephropathy. 388 9

An earlier and more manifested affect of glomerular function was established during the examination of 35 patients with diabetic nephropathy, 14 of them in a stage of renal insufficiency, with the help of radioisotope clearance methods (of EDTA, labelled with 169Yb for the determination of glomerular function and of hippuran, labelled with 131J for the determination of the renal plasma flow). The renal plasma flow is affected to a considerably more restricted extent. The combination of diabetic nephropathy with chronic pyelonephritis, found in 10 patients, does not affect substantially the mentioned functions of the kidney, but additional investigations were considered necessary in that field. Bilateral symmetric alterations are more frequently the secretory and excretory segmentsmthe establishment of unilateral alterations may speak of the presence of chronic pyelonephritis of uropathic character. The radioisotope methods, because of their accessibility and less possibilities for errors are recommended for renal functional investigations.
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PMID:[A study of renal function using radioisotope methods in patients with diabetic nephropathy]. 421 76

We report two patients with terminal renal failure secondary to diabetic nephropathy treated with cadaveric kidney transplantation. Neither of these patients had peripheral vascular disease or peripheral neuropathy. There was a proliferative diabetic retinopathy with hemorrhages and exudates in one patient and only background diabetic changes in the ocular fundi of the other; there have been no significant changes in visual acuity or retinopathy in either patient following the transplantation. Both have good kidney function after 8 and 15 months and are completely rehabilitated.The requirement for insulin decreased in both patients during the period of renal insufficiency and increased following transplantation; this seemed to be related to the large dose of steroids given because now that a maintenance level of steroids has been established, both patients require the same dosage of insulin as they did before the onset of renal insufficiency.
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PMID:Treatment of renal failure from diabetic nephropathy with cadaveric homograft. 457 72

The onset of fixed proteinuria and hypertension in insulin-dependent diabetic is generally associated with eventual renal insufficiency due to diabetic nephropathy or with a superimposed glomerulopathy. We report three adolescents with normal renal function who developed fixed proteinuria and hypertension after only 7 to 11 years of insulin-dependent diabetes mellitus. Blood pressure ranged from 130/95 to 165/104 mmHg, urinary protein excretion was 1.31 to 1.37 g/24 hours, and creatinine clearance ranged from 98-133 ml/min/1.73 m2. Renal biopsy revealed changes consistent only with diabetic glomerulosclerosis. Follow-up evaluation for 11 months to 3 1/2 years revealed blood pressure reductions to 125/78-140/85 mmHg as a result of antihypertensive medications. Creatinine clearance increased by 12-20% and urinary protein excretion remained unchanged. We conclude that these patients may represent an unusual subgroup of insulin-dependent diabetics with early development of clinical and pathological diabetic nephropathy in the face of normal renal function.
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PMID:Early onset of clinical diabetic nephropathy in children--a new subgroup? 671 12

This communication describes the electron microscopic study of a renal biopsy specimen from a patients with diabetic nephropathy, the nephrotic syndrome, and renal insufficiency. There were large amounts of electron dense materials within glomerular basement membranes and masses of fibrin within glomerular capillaries and Bowman's spaces. The presence of glomerular fibrin suggests that thrombosis may be pathogenetically related to diabetic nephropathy.
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PMID:Diabetic nephropathy associated with fibrin formation. 702 1

Diabetic nephropathy with renal failure is a major cause of death among juvenile diabetics. It is as yet unknown why some diabetics suffer from this serious renal complication while others do not, in spite of long duration of diabetes. For therapeutic reasons it is of the utmost importance to find out which patients are at risk long before the manifestation of renal insufficiency. Juvenile diabetics are know to have an increased frequency of some HLA antigens. The relationships between the HLA-A, HLA-B and HLA-C antigens and diabetic end-stage nephropathy were therefore evaluated in the present study. The study comprised 121 insulin-dependent diabetics with renal failure (mean age at onset of diabetes 13.4 leads to 7.6 (SD) years, mean pre-uraemic duration of diabetes 21.7 leads to 4.7 years), and 36 insulin-dependent diabetics (mean age at onset of diabetes 16.5 leads to 8.4 years) without renal failure despite long mean duration of diabetes (32.5 leads to 5.1 years). We found the expected significant increase in B8 and B15 and a decrease in B7 frequencies in the diabetics compared with the non-diabetic population, but no difference was found between uraemic and non-uraemic diabetics. Neither the early onset of diabetes nor the rapid appearance of renal failure was associated with any HLA frequency. The data therefore do not provide evidence of the involvement of B8 or B15 allele-associated mechanisms in the disease process leading to diabetic nephropathy with renal failure. There was a significant difference (p corrected less than 0.01) between the frequency of Bw22 in uraemic diabetics (14%) and that in non-diabetics (5%) while the frequency was near normal in non-uraemic diabetics. Further data are needed to confirm the possible association of Bw22 with diabetic nephropathy.
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PMID:HLA-antigen distribution in juvenile diabetics with end-stage nephropathy. 723 15


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