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Diabetic Nephropathy Overview

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Elevated Blood Urea Nitrogen (BUN)

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Increased BUN indicates reduced kidney function. Management includes dietary protein restriction, adequate hydration, and medications to control the progression of kidney disease.

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Anemia

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Often a consequence of decreased erythropoietin production by damaged kidneys. Treatment includes erythropoiesis-stimulating agents, iron supplements, and potentially blood transfusions.

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Albuminuria

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The presence of albumin in the urine, indicating kidney damage. Treatment includes ACE inhibitors or ARBs to reduce proteinuria and control of blood glucose and blood pressure.

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Glomerular Hyperfiltration

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High filtration rate in the kidneys that can lead to kidney damage over time. Control of blood glucose and hypertension is crucial; potential role for medication that targets the glomerular filtration rate.

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Tubulointerstitial Fibrosis

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Scarring in the tissues surrounding the kidney tubules, it worsens kidney function. Management includes ACE inhibitors/ARBs, blood glucose control, and potentially anti-fibrotic agents.

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Podocyte Injury

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Damage to the cells that help maintain the filtration barrier in kidneys, leading to protein loss. Treatment focuses on controlling blood sugar and blood pressure, and using medications that reduce protein loss.

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Glomerular Basement Membrane Thickening

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Thickening of kidney filters that impedes function. No specific treatment, but good glycemic and blood pressure control are essential to slow progression.

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Renal Hypertrophy

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Kidney enlargement as an early response to diabetes, which can lead to further damage. Treatments aim to control blood sugar and blood pressure to reduce kidney stress.

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Advanced Glycation End Products (AGEs)

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These compounds, formed from high blood sugar, contribute to kidney damage. Treatment is focused on tight blood glucose control to limit AGE formation.

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Decreased Glomerular Filtration Rate (GFR)

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This rate decrease is indicative of reduced kidney function. Treatment strategies focus on modifiable risk factor control such as hyperglycemia, hypertension, and albuminuria management.

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