Complications > Kidney

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Diabetic kidney disease in disadvantaged people

A rising frequency of diabetic kidney disease worldwide is disproportionately affecting disadvantaged people. Among the hardest hit are people in the poorest countries, which lack the public health infrastructure to address the epidemic using treatments widely available in the developed world. In this article, Robert Nelson examines the frequency of diabetic kidney disease in various parts of the world, explores some reasons why disadvantaged populations may be particularly vulnerable to this complication of diabetes, and describes how health-care providers may successfully

Pregnancy and diabetic nephropathy

Twenty years ago, medical opinion was against women with diabetic kidney disease (nephropathy) proceeding with pregnancy. With new technology and increasing experience, the outcome for these women and their children has improved substantially. Over the last decade, there has been a substantial decline in the number of women with diabetic nephropathy who die during pregnancy, childbirth and early maternity. Successful pregnancies with fetal survival rates of up to 95% are now achievable in women with diabetes who suffer kidney damage.

Anaemia: a silent complication of diabetes

Tiredness and lethargy are associated with diabetes, but are usually due to uncontrolled blood glucose (sugar) levels. However there may be other causes of tiredness as in the rest of the population, and these include anaemia. Awareness of anaemia in diabetes is low, both among patients and health-care professionals. Yet if anaemia is diagnosed and corrected, the result can be a major change in quality of life. One cause of anaemia in people with diabetes is kidney disease.

Prevention and diabetic kidney disease

Diabetic kidney disease (nephropathy) is a major cause of death in people with diabetes. It affects about one-third of people with the condition. Recent studies have demonstrated that the onset and course of diabetic nephropathy can be improved very significantly by several kinds of intervention. However, these interventions have their greatest impact if made before or very early in the course of the development

Management of early diabetic nephropathy

The number of people with diabetes is increasing worldwide mainly because of an increase in Type 2 diabetes. Diabetes is now the leading cause of end-stage renal disease (ESRD) in Western countries. Diabetic kidney disease (nephropathy) has been reported to occur in 25-40% of people with Type 1 or Type 2 diabetes. People with diabetes, especially those with kidney complications, also face an increased risk of death from cardiovascular disease (CVD).

Screening and diagnosis of diabetic nephropathy

Screening for diabetic kidney disease (nephropathy) or its earlier stage, microalbuminuria, is important. The person with diabetes and the carer both need to know with absolute certainty whether nephropathy is developing. They need to know because it is possible to prevent or at

End-stage kidney disease: option and problems

While fewer people with Type 1 diabetes are developing end-stage kidney disease (end-stage diabetic nephropathy, ESDN), the number of people with Type 2 diabetes reaching ESDN is growing rapidly. In this article, Eberhard Ritz answers some key questions about the issues around care for people with diabetes who suffer ESDN.

A year of concentration on kidneys

President's editorial

It's all kidneys

Editor-in-Chief's editorial

Pancreas and islet transplantation in the management of diabetes

The relative roles of pancreas transplantation and islet transplantation in the management of diabetes are perhaps best examined in the context of the American Diabetes Association (ADA) position statement - revised in 2003. Given the growing success of islet transplantation, it seems worthwhile to examine whether the ADA recommendations should be reconsidered.

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