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06-05-2009, 09:32 AM
Diabetic nephrophropathy


♣It is not a glomerulonephritis but is considered to be glomerulopathy.
♣It Occurs in type I, II, but it is common in type I due to long natural history
♣It is related to control of Diabetes and also to duration (10-15yrs).
♣Usually it is a part of Diabetic triopathy :

retinopathy Nephropathy Neuropathy

C/P D.M. + nephrotic $ C.R. F.
Early diagnosis by appearance of micro albuminuria.
Micro glomerulosclerosis (there is thickening of B.M.)
Sonar normal or large kidney size.
ttt
· Control of bl. sugar prevent the early hyperfiltration
· ACE inhibitor vasodil. Of efferent arteriole.
arteriole ¯ intra glomerular pressure
¯ process of glomerulosclerosis
post pond C R F
N.B : Diabetic nephropathy diagnosis does not depend upon
renal biopsy

N.B. (problems)
Pt with B nephrotic$=B nephropathy FSGS- member.prolif)
G. L. adenopathy nephrotic $
AIDS lymphoma
FSGS minimal L.
Fever then nephrotic

FMF chr. Malaria (malarial nephropathy)

abd. Pain huge spleen ++
Arthropathy nephrotic $
SLE Rheumatoid amyloidosis kid.
nephrotic $ : drugs:NSAID
penicillamine gold
Pt with D.M. nephrotic $ = diabetic nephrop

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)