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Kidney Disease (3,19,21,23)
Kidney disease is a serious complication of DM and damage may go undetected during the initial stages of the disease. The pathophysiology of renal disease is more clearly understood in Type 1 than Type 2.
Diabetic Nephropathy
Thickening of the glomerular basement membrane can occur early after the diagnosis of diabetes. Laboratory evidence of damage generally appears after 10 years and is accelerated by hypertension in individuals with Type 1. This life-threatening complication is the leading cause of end-stage renal disease (ESRD). Approximately 40 percent of Type 1 diabetics with a diagnosis of 20+ years develop this complication. 5 to 10 percent of Type 2 diabetics are affected with diabetic nephropathy. The first sign of diabetic nephropathy may be protein present in urine.
African Americans with diabetes are at least two times more likely to develop ESRD than Caucasians. Treatment(s) for diabetic nephropathy resulting in kidney failure include, hemodialysis, peritoneal dialysis and kidney transplants. Because this condition proceeds more rapidly in diabetic patients, strict monitoring and treatment of hypertension and frequent renal function measurements should be instituted.
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