(Renal & Urolgy)

Overview

• Usually a clinical diagnosis in a patient with long-standing diabetes (>10 years) with albuminuria and/or reduced estimated glomerular filtration rate (eGFR)
• Most common cause of CKD
• Developed by approximately 20% to 40% of patients with type 1 or type 2 diabetes mellitus
• Major Histological Changes → mesangial expansion, glomerular basement membrane thickening, glomerulosclerosis

Making Diagnosis

Clinical Features:

• Hypertension
• Oedema → in advancing diabetic nephropathy
• Polyuria
• Lethargy
• Signs of Retinopathy → usually develops alongside nephropathy. Blot haemorrhages, microaneurysms, neovascularisation

Investigations:

• First Line: Urinalysis → increased albumin:creatinine ratio (ACR) = microalbuminuria
  • ACR >2.5 = microalbuminuria
  • All patients should be screened annually using urinary ACR