Early renal dysfunctions in type 1 diabetes and pathogenesis of diabetic nephropathy

Gianpaolo Zerbini, Daniela Gabellini, Silvia Maestroni, Anna Maestroni

Research output: Contribution to journalArticle

Abstract

Diabetic nephropathy develops in only a subgroup of patients affected by type 1 diabetes. Once established, this complication is quite difficult to control, and consequently its prevention is presently considered the first target to achieve. As hyperglycemia has immediate effects on renal function and structure, it is reasonable to say that, in predisposed individuals, the pathogenesis of diabetic nephropathy also begins with the onset of diabetes. Two major hypotheses have been put forward to explain how the renal abnormalities that characterize the first years of diabetes - i.e., hyperfiltration and hypertrophy - will later lead to the appearance of microalbuminuria and end-stage renal disease. The first hypothesis considers hyperfiltration as the driving dysfunction and hypertrophy as the consequence. Conversely, the second points to proximal tubule hypertrophy as the starting point and hyperfiltration as the result. Whatever the case, tight glucose control from the very first days of disease seems to be the only established therapy to prevent future complications in type 1 diabetes.

Original languageEnglish
JournalJournal of Nephrology
Volume20
Issue numberSUPPL. 12
Publication statusPublished - Nov 2007

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Diabetic Nephropathies
Type 1 Diabetes Mellitus
Hypertrophy
Kidney
Hyperglycemia
Chronic Kidney Failure
Glucose
Therapeutics

Keywords

  • Diabetic nephropathy
  • Hyperfiltration
  • Hypertrophy
  • Tubular hypothesis
  • Type 1 diabetes
  • Vascular hypothesis

ASJC Scopus subject areas

  • Nephrology

Cite this

Early renal dysfunctions in type 1 diabetes and pathogenesis of diabetic nephropathy. / Zerbini, Gianpaolo; Gabellini, Daniela; Maestroni, Silvia; Maestroni, Anna.

In: Journal of Nephrology, Vol. 20, No. SUPPL. 12, 11.2007.

Research output: Contribution to journalArticle

Zerbini, G, Gabellini, D, Maestroni, S & Maestroni, A 2007, 'Early renal dysfunctions in type 1 diabetes and pathogenesis of diabetic nephropathy', Journal of Nephrology, vol. 20, no. SUPPL. 12.
Zerbini, Gianpaolo ; Gabellini, Daniela ; Maestroni, Silvia ; Maestroni, Anna. / Early renal dysfunctions in type 1 diabetes and pathogenesis of diabetic nephropathy. In: Journal of Nephrology. 2007 ; Vol. 20, No. SUPPL. 12.
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