The Incidence And Severity Of Diabetic Nephropathy

Underdiaxonsied and undertreated it is a major concern for the aging population of the United States. One of the first steps is educating the public on early detection techniques and risk factor for developing CKD. High blood pressure and diabetes is a major contributor in developing the disease and thus high risk factor groups should be identified early. This way the individuals can begin implementing lifestyle changes that can not only decrease the rate of kidney function decline but improve it as well. Management of the disease focus on the major complications. Anemia, dyslipidemia, CKD-MBD, nutrition and cardiovascular are the forefront of the disease management. Management with not only medications, but lifestyle changes creates a holistic care plan specialized to each individual patient. By treating not CKD but the individual patient, outcomes will improve. Implementing the health care team as a whole will unify the strengths in modern medicine and thus relieve a huge financial burden that chronic kidney disease yields at a national and local

Kidney disease. In 2011, diabetes was listed as the primary cause of 44% of all new cases of kidney failure (CDC, 2014). Data showed that 228,924 individuals with kidney failure due to diabetes required chronic dialysis or a kidney transplant (CDC, 2014).

Diabetes is a chronic, systemic disturbance in the metabolism of blood glucose; hence blood levels of glucose are abnormally high. This is either due to the body’s inability

The American Association of Clinical Endocrinologist (AACE) treatment goals are individualized and aimed at lowering A1C and prevention of hypoglycemia along with decreased comorbidities associated with diabetes. Diabetics who are at an increased risk for hypoglycemia include: a diagnosis of greater than 15 years, advanced macrovascular disease, hypoglycemia unawareness, limited life expectancy and severe comorbidities (Garber, Blonde, Bush, Einhorn, & Garber,et al., 2017). In addition Fowler (2010) notes that those with renal or hepatic dysfunction are at an increased risk for hypoglycemia due to the combination of less endogenous glucose production and longer insulin half life. This combination can result in a rapid lowering of glucose.

The writer will examine the prevalence of diabetes among the patients with end-stage renal disease (ESRD), potential benefits, and harm during management of underlying cause, and analysis of glycemic index hemoglobin A1c (HgbA1c) in managing diabetic ESRD patients. Diabetes is one of the frequent reasons and common persistent complications of ESRD (Kovesdy, Park, & Kalantar-Zadeh, 2010). According to the United States Renal Data System (USRDS), diabetes is the primary cause leading to ESRD. Among 20.8 million diabetic population, approximately 232,984 were affected by ESRD that accounted for increase in Medicare budget from 5.4% to 6.3% at the end of 2011 (United States Renal Data System [USRDS], 2013). Not everyone with diabetes develop ESRD, thus strictly controlling blood sugar level lower the chances of getting kidney disease (Mehrotra, Kalantar-Zadeh, & Alder, 2011).

inverse relationship to GFR. Thus, a rise in S.Cr is associated with a corresponding decrease in GFR and generally implies a reduction in kidney function and vice versa.

High levels of blood sugar caused by diabetes can cause the kidneys to filter too much blood. This overexertion can be hard on the kidneys and eventually they can start to leak and can be lost in the urine. If this is not caught early enough the extra work the kidneys are doing can cause them to lose their ability to filter allowing waste to build up in the blood and eventually leading to kidney failure. Individuals with diabetes are more likely to develop certain problems and diseases along with its effects on the different systems of the body.

To understand the reason behined one of the major causes of morbidity and mortality in diabetic patients that is coronary artery diseases.

Over time, diabetic patients can affect the heart, blood vessels, eyes, kidneys, and nerves. The adults with diabetic will be at risk of getting heart attacks and stroke because of micro vascular and macro vascular involvement. Cases associated with decreased lower blood circulation and neurological damage (nerve damage) increase the likelihood of foot ulcers with infection and infiltration leads to lower limb amputations. Diabetes may be responsible for 2.6% of global blindness. Diabetic is a major cause of kidney failure

Diabetic Nephropathy (DN) is a serious and progressive complication of both type 1 DM (Results from the body’s failure to produce insulin) and type 2 DM (Results when the pancreas does not produce enough insulin to control glucose level or

Abdel-Rahman, E.M., Balogun, R.A., &Balogun, S.A. (2014). Chronic kidney disease: Signs /symptoms, management options and potential complications. NewYork: Nova Science Publishers.

Obesity can affect the kidneys, not just as a side effect from illness such as hypertension, diabetes

Nevertheless, no available treatment has been able to halt the progression to end-stage renal failure, thus new therapeutic modalities to manage diabetic nephropathy are needed.

participant in sterilized urine containers and used to determine albumin in 24 h urine specimen. The urine levels of the biomarkers were normalized to the urinary creatinine concentration to control for variations in hydration status. Serum and urinary TNF-α: serum levels were measured by an enzyme-linked immune absorbent assay (ELISA) using commercially available standard kits (Quantikine high-sensitivity human TNF-α Research & Diagnostic Systems, Europe Ltd, Abington, UK). The urinary concentration of TNF-α was determined using an enzyme-linked immunosorbent assay (ELISA) with a Human TNF-α Quantikine ELISA kit (DTA00C; R&D systems, Minneapolis, MN, USA). The study protocol was approved by the Ethical Committee of Faculty of Medicine, Zagazig University and informed written consent was obtained from each individual. Statistical analyses Were performed using the Statistical Package for the Social Sciences for Windows (version 22.0; SPSS Inc., Chicago, IL, USA). Data were expressed using descriptive statistic (mean ± standard deviation) and were analyzed. One-way analysis of variance (ANOVA) test was done to compare different parameters between more than two groups. Pearson correlation coefficient was used to assess the association between serum and urinary TNF-α levels, clinical, biochemical tests and other studied metabolic parameters in patients with diabetic nephropathy. P-values were considered significant if < 0.05).On the other hand there were no significant

To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose-lowering levels in patients with diabetics and Chronic Kidney Disease (CKD).