The kidney is one of the main victims of diabetes mellitus. The systemic changes caused by the disease lead to progressive glomerular and vascular damage.
Diabetic nephropathy describes the progressive fibrosis and scarring of the glomeruli, leading to albuminuria, reduced GFR, and eventually, end-stage kidney disease.
- Together with hypertension, diabetes mellitus is a major cause of kidney disease.
- Hyperglycemia leads to an array of hemodynamic and metabolic changes.
- It is the most common cause of end-stage kidney disease, and nephrotic syndrome in adults.
- Renal disease due to DM type 1 is more common than due to DM type 2.
- The hallmark of the disease is glomerulosclerosis - the accumulation of extracellular matrix (ECM) proteins in the mesangial interstitial space, resulting in fibrosis and scarring.