Diabetic Nephropathy: From 1 Different Sources
progressive damage to the kidneys seen in some people with long-standing diabetes. Excessive leakage of protein into the urine is followed by gradual decline of the kidney function and even kidney failure. See also diabetic glomerulosclerosis.
Disease of the kidneys... nephropathy
n. disease of the *tubulointerstitium of the kidney associated with chronic use of mixed analgesic preparations. Phenacetin, paracetamol, and salicylates have all been implicated. The condition is progressive and results in bilateral atrophy of the kidneys and chronic renal failure. In the early stages the condition is asymptomatic. The earliest clinical manifestations relate to disordered tubular function with impaired concentration and acidification of the urine.... analgesic nephropathy
a severe and progressive form of tubulointerstitial renal disease (see tubulointerstitium), first described in 1956 and endemic to certain rural areas along the tributaries of the Danube in Bosnia, Bulgaria, Croatia, Romania, and Serbia. The natural course of the disease is progression to end-stage kidney failure and frequent development of tumours in the upper urinary tract. It seems likely that an environmental factor is responsible for the disease, and evidence supports the theory that long-term consumption of food contaminated with seeds from plants of *Aristolochia spp. underlies the pathogenesis.... balkan nephropathy
(IgA nephropathy) an abnormality of the kidney in which there is a focal area of inflammation (*glomerulonephritis). This causes microscopic amounts of blood in the urine. A quarter of the patients with this condition may develop kidney failure. [J. Berger (20th century), French nephrologist]... berger’s nephropathy
(myeloma kidney) a complication of multiple myeloma seen in approximately half of those who have renal disease. The casts typically involve the distal convoluted and collecting tubules and often have a fractured or crystalline appearance. They are frequently surrounded by multinucleate giant cells. Deposition of the casts is associated with progressive renal failure.... cast nephropathy
a condition that came to prominence in the 1990s when hundreds of young European women developed end-stage renal disease after receiving slimming pills containing Chinese herbs. The condition is also associated with a high incidence of urothelial tumours. It was eventually proved that the product was contaminated with aristolochic acid, a main toxic product of *Aristolochia plant species. Its presence in the slimming regimen was the result of accidental substitution of the prescribed herb Stephania tetrandra (han fang-ji) by A. fangchi (guang fang-ji).... chinese herb nephropathy
deterioration in renal function (of more than 25%) after administration of radiocontrast material. Development of this condition is more likely when there is pre-existing renal disease (the most important factor) or diabetes, vasoconstriction, simultaneous use of NSAIDs, and large amounts of radiocontrast are used. It is thought that the radiocontrast induces vasoconstriction in the vessels supplying the medulla of the kidney and aggravates hypoxia in this part of the kidney.... contrast nephropathy
an acute mononeuropathy of the femoral nerve, usually of microvascular origin, associated with chronic poor diabetic control. Symptoms are thigh pain and progressive weakness of knee extension. Examination reveals wasting of the quadriceps muscle group and loss of the knee jerk. It may affect both legs and recovery is usually slow. Treatment is with physiotherapy and improved control of the diabetes; the condition never seems to recur in the same leg. The main *differential diagnosis is of compression of the nerve roots in the spinal canal.... diabetic amyotrophy
the characteristic microscopic changes seen in a diabetic kidney after many years of progressive damage.... diabetic glomerulosclerosis
the combination of features, often found in the hands of long-standing diabetic subjects, consisting of *Dupuytren’s contractures, knuckle pads, *carpal tunnel syndrome, *cheiroarthropathy, and sclerosing *tenosynovitis.... diabetic hand syndrome
a condition in which patients with diabetic sensory polyneuropathy (see diabetic neuropathy) suffer significant trauma to their insensate feet through holiday activities. These may include walking on hot flagstones or sand and wearing ill-fitting shoes. The condition may be prevented with prior education and advice and by maintaining safe footcare practices.... diabetic holiday foot syndrome
a well-recognized period just after the diagnosis of type 1 *diabetes mellitus when only very low insulin doses are required to control the condition. It lasts from months to a few years but inevitably ends, when dose requirements will increase quite quickly.... diabetic honeymoon period
(DKA) a metabolic state resulting from a profound lack of insulin, usually found only in type 1 *diabetes mellitus but sometimes arising in people of Afro-Caribbean ethnicity with type 2 diabetes. Inability to inhibit glucose production from the liver results in *hyperglycaemia, which can be extreme and lead to severe dehydration. The concurrent failure to suppress fatty-acid production from adipose tissue results in the excess conversion of fatty acids to ketones in the liver (*ketosis) and the development of a metabolic *acidosis, which can be severe. Patients often present with vomiting (from the ketosis), which contributes to the dehydration. The condition is treated as a medical emergency with intravenous fluid and insulin; patients should be monitored in high-dependency units.... diabetic ketoacidosis
progressive damage to the peripheral nerves seen in some people with long-standing diabetes. It most commonly affects the legs, causing pain or numbness working up from the feet. There is no cure but drugs can sometimes be used to control the discomfort experienced, and good blood glucose control may prevent deterioration over time. See also diabetic holiday foot syndrome.... diabetic neuropathy
see retinopathy.... diabetic retinopathy
see HAN.... heroin-associated nephropathy
defects of kidney function related to a high serum calcium, irrespective of cause. Impaired urine-concentrating ability and reduction in glomerular filtration rate are common features. Histologically, calcific deposits in the kidneys (*nephrocalcinosis) may be seen in cases of long-standing hypercalcaemia.... hypercalcaemic nephropathy
abnormalities seen with chronic hypokalaemia (usually K+ <3.0 mmol/l) and manifest by impaired urine-concentrating ability and reduced capacity to excrete sodium. Histological changes include cytoplasmic vacuolation of the renal tubules and medullary fibrosis.... hypokalaemic nephropathy
see Berger’s nephropathy.... iga nephropathy
a common cause of the *nephrotic syndrome in adults. The diagnosis is established by renal biopsy, which shows diffuse global subepithelial deposits within the glomerulus. Most cases of membranous nephropathy are idiopathic, but there are associations with infection (e.g. hepatitis B), malignancy (especially lung cancer), autoimmune disease (e.g. SLE, Hashimoto’s disease), and drugs (e.g. gold and penicillamine). Recent studies suggest that idiopathic membranous nephropathy is an autoimmune disease with antibodies directed against an antigen (PLA2R, a phospholipase A2 receptor) on the *podocyte cell membrane. Without treatment, outcome is very variable: some patients will make a full recovery, while others will progress to end-stage kidney failure. Immunosuppressant treatment is often tried when there is evidence of declining renal function.... membranous nephropathy
the commonest cause of *nephrotic syndrome in children and an important cause of this syndrome in adults. The condition is so named because of the apparent lack of abnormalities seen on light microscopy of biopsy samples. Changes can, however, be seen on electron microscopy, with effacement of the *podocyte foot processes along the glomerular basement membrane. It is postulated that minimal change disease is a T-cell disease and that *cytokine damage to the podocytes leads to loss of the selective filtering characteristics of the glomerulus. The condition usually responds to corticosteroids and has a good prognosis, but there is clinical overlap with primary *focal segmental glomerulosclerosis, which may have similar histological appearances in its early stages, tends not to respond to steroids, and is associated with a poor renal prognosis.... minimal change nephropathy
progressive renal disease developing in 5–8% of patients with *sickle-cell disease. Infarcts in the cortex can occur with sickle-cell crises and present with pain and haematuria. Acute or more insidious damage to the medulla will lead to a urinary concentrating defect and later to papillary necrosis and/or fibrosis. Occlusion of vessels within the glomerular capillary tuft leads to a secondary form of *focal segmental glomerulosclerosis and can present with the *nephrotic syndrome.... sickle-cell nephropathy
Health Encyclopedia