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Diabetic nephropathy
It can be roughly divided into these stages:
• It is asymptomatic initially, and does not produce symptoms until it becomes in an advanced stage.
• Microalbuminuria (without reduction in GFR or BP changes).
• Macroalbuminuria with GFR reduction and hypertension.
• End-stage renal failure: It is the most common cause of end-stage renal disease (ESRD) in the United States.
• It is asymptomatic initially, and does not produce symptoms until it becomes in an advanced stage.
• Microalbuminuria (without reduction in GFR or BP changes).
• Macroalbuminuria with GFR reduction and hypertension.
• End-stage renal failure: It is the most common cause of end-stage renal disease (ESRD) in the United States.
Lab Rats In Lab Coats
Diabetic nephropathy
The recommended screening test is spot ACR (Albumin-Creatinine-Ratio). Preferably a first-void, or alternatively, early-morning specimen.
Normal < 30 mg/g
Microalbuminuria = 30-300 mg/g
Macroalbuminuria > 300 mg/g
Normal < 30 mg/g
Microalbuminuria = 30-300 mg/g
Macroalbuminuria > 300 mg/g
Lab Rats In Lab Coats
Diabetic nephropathy
ADA recommends annual screening for microalbuminuria beginning at the time of diagnosis for patients with type 2 DM, and starting at year 5 for patients with type 1 DM.
Because of the variability of ACR, 2 of 3 specimens in a 3- to 6-month period should be abnormal before diagnosing new or progressive diabetic nephropathy.
Because of the variability of ACR, 2 of 3 specimens in a 3- to 6-month period should be abnormal before diagnosing new or progressive diabetic nephropathy.
Lab Rats In Lab Coats
ADA recommends annual screening for microalbuminuria beginning at the time of diagnosis for patients with type 2 DM, and starting at year 5 for patients with type 1 DM. Because of the variability of ACR, 2 of 3 specimens in a 3- to 6-month period should be…
ليش؟
لأن الـ natural history مال المرض يختلف بين النوع الأول والنوع الثاني
لأن الـ natural history مال المرض يختلف بين النوع الأول والنوع الثاني
بالسكري من النوع الأول، الـ microalbuminuria بالعادة تظهر بعد شي 10 سنوات، وراها تتطور إلى الـ stages اللي ذكرتهن فوك خلال 10 إلى 20 سنة
بينما بالنوع الثاني:
Natural history is less well defined because the onset of type 2 DM is usually not well defined, and other causes of kidney disease (such as hypertension and vascular disease) are common comorbidities.
بينما بالنوع الثاني:
Natural history is less well defined because the onset of type 2 DM is usually not well defined, and other causes of kidney disease (such as hypertension and vascular disease) are common comorbidities.
The treatment is basically:
• First and foremost: tight glycemic control reduces both the risk and the progression of the nephropathy.
• Control the BP via ACE inhibitors or ARBs. This has the dual effect of reducing both hypertension and proteinuria (ACEi and ARBs were found to reduce proteinuria in general. i.e. in nephrotic syndrome). But they should not be used together; doing so increases the incidence of acute kidney injury and hyperkalemia without leading to benefits beyond using either agent alone.
• First and foremost: tight glycemic control reduces both the risk and the progression of the nephropathy.
• Control the BP via ACE inhibitors or ARBs. This has the dual effect of reducing both hypertension and proteinuria (ACEi and ARBs were found to reduce proteinuria in general. i.e. in nephrotic syndrome). But they should not be used together; doing so increases the incidence of acute kidney injury and hyperkalemia without leading to benefits beyond using either agent alone.
بقن بس الـ crises مالته:
• Hypoglycemia
• DKA
• Hyperglycemic Hyperosmolar state (HHS)
• Hypoglycemia
• DKA
• Hyperglycemic Hyperosmolar state (HHS)
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So...
بعدني ما كاتب شي، عليمن الگلوب😂
So far, we have:
• Gray baby syndrome
• Red man syndrome
• Blue man syndrome
• Orange breast (Peau d'orange)
• Cherry angioma
• Berry aneurysm
• Gray baby syndrome
• Red man syndrome
• Blue man syndrome
• Orange breast (Peau d'orange)
• Cherry angioma
• Berry aneurysm