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Nephrology Dialysis Transplantation, Vol 13, Issue 90008 16-19, Copyright © 1998 by Oxford University Press

ORIGINAL ARTICLES

Progression of renal failure in diabetic nephropathy

C Marcantoni, V Ortalda, A Lupo and G Maschio
Division of Nephrology, University of Verona, Verona, Italy; Corresponding author at: Divisone di Nefrologia, Ospedale Civile Maggiore, 37126 Verona, Italy

The onset of renal damage in diabetes mellitus may be influenced by several factors which largely results from genetic predisposition, hereditary factors and the early appearance of microalbuminuria and/or systemic hypertension. Most of these factors are also implicated in the progression of nephropathy from microalbuminuria to overt proteinuria and to end-stage renal failure (ESRF). Over the last few years, the role of hyperglycaemia has emerged as critical in mediating the progressive renal damage in diabetes. However, hyperglycaemia leads to increased formation of glycated proteins which may act as promoters of progression by localizing in renal tissue. In addition, hyperglycaemia may have a synergistic effect and the renin-angiotensin system, in accelerating renal deterioration.Key words: diabetic nephropathy; hyperglycaemia; hypertension; progression of renal failure; proteinuria; renin-angiotensin system
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