Diabetic nephropathy

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The development of proteinuria in any diabetic patient is ominous. It is associated with a risk of severe retinopathy and neuropathy, and above all carries a major increased risk in mortality from coronary artery disease, as well as progression to renal failure in some patients. Yet developments in this field to improve the prognosis have been substantial. The overall prevalence of proteinuria in Type 1 diabetes has decreased over half a century from more than 50% of patients down to between 10 and 20%, presumably as a result of better overall diabetic care. Furthermore, at the earliest sign of proteinuria, administration of medication and very tight blood pressure control ameliorate the course of the disease and substantially delay the development of renal failure. And for those who are less fortunate, transplantation and dialysis restore a good quality of life to the majority.

Proteinuria occurs in both Type 1 diabetes and Type 2 diabetes. African-Caribbean and Asian Type 2 diabetic patients have a much higher prevalence of this disease and its associated morbidity.

Cumulative incidence of nephropathy in patients diagnosed with Type 1 diabetes over a 20-year span

Incidence of diabetic nephropathy in Type 1 diabetic patients

Year after onset of proteinuria

Incidence of diabetic nephropathy in Type 1 diabetic patients

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