The role of haemodynamic and metabolic factors in the development of diabetic nephropathy
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 3
Abstract
Diabetic nephropathy results from the interaction of various factors (metabolic, hemodynamic, neurogenic, and toxic ones) in a genetically predisposed diabetic patient. Up to 50% of diabetics are affected. This manuscript reviews the role of hemodynamic and metabolic factors in the development of diabetic nephropathy. First, the role of glomerular blood pressure changes is described, together with different factors that may influence it in different mechanisms. Then, metabolic factors like hyperglycemia, dyslipidaemia and excess dietary protein intake are addressed. Special attention was paid to hyperglycemia. Four mechanisms associated with it are described, Glucotoxicity, non-enzymatic glycosylation, polyol pathway activation and oxidative stress, all may contribute to development of nephropathy in patients with diabetes. Therefore it seems that also treatment of this complication should be multifactorial.
Authors and Affiliations
Władysław Grzeszczak, Grzegorz Wystrychowski, Edward Franek
Keywords
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