By Christoph Hasslacher
This quantity will specialise in and emphasise the medical relevance of diabetic nephropathy, a comparatively universal challenge of diabetes. It impacts approximately one in 3 sufferers with variety 1 diabetes, and left untreated may end up in a revolutionary decline in renal functionality, followed by way of retinopathy and arterial high blood pressure, which, in flip, results in heart problems - a standard reason behind dying in those sufferers. Diabetic Nephropathy also will give you the reader with a high-quality grounding in present easy and scientific learn.
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Example text
At the time of diagnosis, 15±30% of these patients show microalbuminuria and 2±8% already macroalbuminuria (6±8). In response to metabolic normalization by diet or oral hypoglycaemic agent, elevated AER declines during weeks and months. In contrast to type 1 diabetes, elevated AER persists in a significant proportion (10± 48%) of the patients (9,10). This can be an expression of underlying renal damage due to a considerable preceding time of undetected hyperglycaemia. As in type 1 diabetes, persistent microalbuminuria predicts the further progression of nephropathy.
Diabetologia 1997; 40: 1219±26. 55. Telmer S, Christiansen JS, Andersen AR, Nerup J, Deckert T. Smoking habits and prevalence of clinical microangiopathy in insulin-dependent diabetics. Acta Med 1984; 215: 63±8. 56. Norden G, Nyberg G. Smoking and diabetic nephropathy. Acta Med Scand 1984; 215: 257±61. 57. MuÈhlhauser I. Smoking and diabetes. Diabet Med 1990; 7: 10±15. 58. Olivarius ND, Andreasen AH, Keiding N, Mogensen CE. Epidemiology of renal involvement in newly-diagnosed middle-aged and elderly diabetic patients.
A decreased expression of GBM±HS without changes in HSPG core protein staining was found, suggesting a vulnerability in the metabolism of the negatively charged side chain of HSPG in DN. Now that it has become evident that agrin, but not perlecan, is the major HSPG present in the GBM (55), these studies have to be re-evaluated to exclude an altered expression of agrin in DN. The expression of agrin in DN has not been studied so far. Vernier et al (56) described a correlation between GBM HSPG expression and mesangial expansion, using electron microscopy morphometry and histological staining techniques.