BIO 12 Lecture Notes - Lecture 32: Histopathology, Renal Replacement Therapy, Hyperglycemia

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30 Dec 2020
Jeff Koo
Bio 12
Human Physiology
Spring 2020
4 Units
Diabetic Nephropathy
epidemiology of diabetic kidney disease.
Diabetes (especially type 2) is becoming a major issue.
In 1995, only 3 states had a prevalence over 6%; today 6% is the lowest.
Prevalence in higher in Hispanics and African Americans but hovers
around 10% across the board.
Diabetes is the #1 cause of end-stage renal disease, blindness, and
lower extremity amputations
It also raises the risk of CV events by 2-4 fold
About ⅓ of patients with diabetes will develop nephropathy
histopathologic manifestations of diabetic nephropathy.
Might try and just weave this into 3. Stay tuned.
Yup, gonna just weave it in. Makes more sense as a structure/function thing
natural history and clinical stages of diabetic nephropathy.
Hyperfiltration (silent phase)
Functional Changes:
Increase in GFR (unclear why. Somehow related to
hyperglycemia and RAAS activation)
May also show an increase in overall kidney size
Structural Changes:
Glomerular hypertrophy (without proliferation of cells)
Basement membrane thickening
Time course:
5 to 10 years
Microalbuminuria (incipient nephropathy)
Functional Changes:
Development of microalbuminuria (30-300mg of albumin daily)
In order to find this, we need to check a urinary albumin to
creatinine ratio
Needs to be followed closely because GFR and creatinine will
often still be normal
Tends to be associated with other microvascular complications. If you
know someone has retinopathy, you might be able to say they have
nephropathy without getting a biopsy.
Structural Changes:
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