Diabetic nephropathytBenyamin S.I HutagaolGeriatric Department
Sudarso General
HospitalPontianak20121OUTLINEINTRODUCTIONEPIDEMIOLOGYRISK
FACTORSPATHOPHYSIOLOGYSTAGINGDIAGNOSISMANAGEMENT2INTRODUCTIONDN is
an important cause of morbidity & mortality & is now among
the most common causes of ESRF.
It is one of the microvasculer complications of DM
3How Can You Prevent Diabetic Kidney Disease?Maintain blood
pressure 180mmHg systolic), should be encouraged to lower their
blood pressure slowly. Lowering blood pressure has been shown to
delay the progression from microalbuminuria (30-299 mg/day or
20-199 micrograms/min) to macroalbuminuria (>300 mg/day or
>200 micrograms/min).Because it is possible for type 2 patients
to have had diabetes for some time before being diagnosed, a
urinalysis should be performed at diagnosis for these patients.
Type 1 patients are usually diagnosed at or near onset of disease,
therefore screening for urinary albumin can begin 5 years
post-diagnosis.There are three methods used when screening a
patient for microalbuminuria:1) Measurement of the
albumin-creatinine ratio in a random spot collection;2) 24-hour
collection with creatinine, allowing the simultaneous measurement
of creatinine clearance; and3) timed collection (4 hours or
overnight).The preferred method is measurement of the
albumin-creatinine ratio in a random spot collection. The 24-hour
collection and timed collection are rarely necessary to perform,
however at least two of the three tests should show elevated levels
of urinary albumin before a patient is diagnosed as having
microalbuminuria.Treatment of Diabetic NephropathyHypertension
Control - Goal: lower blood pressure to
