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Contribution to Book
Major Risks Indicators for Diabetic Kidney Disease
The Diabetic Kidney (2006)
  • Katherine R. Tuttle, University of Washington
Risks for diabetic kidney disease have traditionally focused on those associated with loss of renal function, particularly glomerular filtration rate (GFR). The ultimate consequence of GFR loss, end-stage renal disease (ESRD), has long been the primary domain for many nephrologists. However, loss of renal function also encompasses many aspects other than GFR. A number of comorbidities result from, or are exacerbated by, damage to the kidney: hypertension, anemia, disordered bone and mineral metabolism, dyslipidemia, and inflammation, among others. Many of these disturbances are more prevalent, occur earlier, and are more severe in diabetes than in other forms of chronic kidney disease (CKD) (1234). Furthermore, they may contribute to further kidney damage, as well as to cardiovascular disease (CVD). The latter issue is of particular concern because most people with diabetes who develop CKD will die of CVD rather than reach ESRD (5). Therefore, kidney damage and associated comorbidities can be viewed as fundamental participants in a self-perpetuating, positive feedback cycle that produces widespread injury to the circulation with multiple target organ consequences. Because diabetes and CKD pose such a high risk of mortality and major adverse events, the purpose of this chapter is to review major risks indicators. Identification of risks allows for development of improved strategies for detection, intervention, and novel therapeutic approaches.
  • Chronic Kidney Disease,
  • Dietary Protein,
  • Mesangial Cell,
  • Renal Plasma Flow,
  • Diabetic Kidney Disease
Publication Date
Pedro CortesCarl Erik Mogensen
Humana Press
Publisher Statement
Although diabetic kidney disease is the most prevalent cause of end-stage renal disease and the disease most often leading to chronic renal replacement therapy and kidney transplantation, there has been, in recent years, a steady increase in basic and clinical knowledge of the problem. In The Diabetic Kidney, a stellar group of international researchers and clinicians joins forces to independently survey recent findings, ideas, and hypotheses about the causes and treatment of diabetic nephropathy. Drawing on many years of experience, the authors cover both the basic pathogenic mechanisms of the disease, as well as many of its clinical aspects of identification, management, and new therapeutic approaches. Not always in total agreement, their views reflect the present state of knowledge and its uncertainties, and offer a composite of different authoritative views on the causes of diabetic kidney disease. Highlights include an entire section devoted to novel approaches to studying diabetic nephropathy with the most advanced molecular techniques, and comprehensive descriptions of the most up-to-date views on the diagnosis and treatment of the disease. 
State of the art and illuminating, The Diabetic Kidney offers both researchers and practicing clinicians a clear understanding of the progress that has been made regarding the pathogenesis of diabetic nephropathy and of the therapeutic interventions needed to prevent its development or treat it.
Citation Information
Katherine R. Tuttle. "Major Risks Indicators for Diabetic Kidney Disease" New York, NYThe Diabetic Kidney (2006) p. 351 - 357
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