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Book Details
Abstract
The prevalence of Diabetes Mellitus is increasing rapidly all over the world and more so in the developing countries. The global burden of diabetes is expected to double between 2000 and 2030, with the greatest increases in prevalence occurring in the Middle East, sub-Saharan Africa and India. Moreover, the development of type 2 diabetes during the childbearing years is also likely to increase, primarily in the developing countries. It has already been established that Diabetes is the most common primary cause leading to end stage renal disease (ESRD) and Diabetic Nephropathy is the leading cause of chronic kidney disease (CKD) in India.
The cornerstones of management of Diabetic Kidney Diseases include early diagnosis of diabetic nephropathy, prevention of its progression and treatment of the co-morbid conditions. Substantial under-diagnosis of both diabetes and chronic kidney disease leads to lost opportunities for prevention. An inadequate or inappropriate care of patients with diabetic kidney disease contributes to disease progression eventually up to a stage that requires renal replacement therapy, which is not a feasible option for many on a long-term basis, especially in a developing country like ours.
This book covers various aspects of diabetic kidney disease in detail and attempts to familiarize the reader with the existing aspects of the conditions as well as touch upon the new advances in the field. The first chapter outlines the extent to which the condition affects the population globally as well as in our country. The second chapter explores the underlying mechanism by which the disease starts and progresses and the pathological markers of the same. The third chapter delineates the clinical and diagnostic markers of the condition. The fourth and fifth chapters speak of the non-diabetic glomerular and non-glomerular diseases in diabetics. The sixth chapter addresses the most important and desirable goal of preventing the progression and ideally the onset of the disease. The seventh chapter puts together the various treatment modalities available and the subsequent chapter explores the management options for cases requiring renal replacement. In addition to the emphasis to Indian literature at the end of each chapter, the ninth chapter is specially included to highlight the salient aspects of this condition from the Indian perspective.
This book will be beneficial not only for the nephrologists, but also for the epidemiologists, medical students, diabetologists and every doctor who deals with diabetes mellitus.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Font Cover \r | Front Cover | ||
Front Matter \r | ia | ||
Copyright | id | ||
ECAB Clinical Update:Nephrology | ie | ||
Diabetic Kidney Disease | if | ||
About the Authors | ig | ||
Contents | im | ||
ECAB Clinical Update InformationDiabetic Kidney Disease | i | ||
Epidemiology and Demography of Diabetic Kidney Disease | 1a | ||
ABSTRACT: | 1a | ||
KEYWORDS | 1b | ||
Prevalence of Diabetes | 1 | ||
Diabetic Nephropathy- A Global Overview | 2 | ||
Indian Scenario of Diabetic Nephropathy | 3 | ||
Conclusion | 5 | ||
Pathophysiology and Pathology of Diabetic Nephropathy | 8a | ||
Abstract | 8a | ||
Keywords | 8b | ||
Pathophysiology of Diabetic Nephropathy | 8 | ||
Role of Genetic Factors in the Development of Diabetic Nephropathy | 8 | ||
Role of Animal Models in Understanding the Pathophysiology of Diabetic Nephropathy | 10 | ||
Role of Hyperfiltration | 10 | ||
Role of Hyperglycemia | 12 | ||
Role of Advanced Glycosylation End Products | 13 | ||
Role of Reactive Oxygen Species | 17 | ||
Role of Polyol Pathway | 18 | ||
Role of Hexosamine Pathway | 19 | ||
Role of Protein Kinase C | 21 | ||
Role of Transforming Growth Factor- | 24 | ||
Role of Renin- Angiotensin System in the Pathogenesis of Diabetic Nephropathy | 26 | ||
Final Common Pathway in the Pathogenesis of Diabetic Nephropathy | 28 | ||
Pathology of Diabetic NePhroPathy | 29 | ||
Gross Pathology | 30 | ||
Microscopic Features | 30 | ||
Light Microscopic Changes | 30 | ||
Immunofluorescence | 33 | ||
Electron Microscopy | 34 | ||
Staging System for Glomerular Pathology | 35 | ||
Conclusion | 35 | ||
Acknowledgments | 35 | ||
Clinical Presentation and Diagnosis of Diabetic Nephropathy | 41a | ||
ABSTRACT | 41a | ||
KEYWORDS | 41b | ||
Introduction | 41 | ||
Clinical Stages of Diabetic Nephropathy | 42 | ||
Stage 1 | 43 | ||
Stage 2 | 43 | ||
Stage 3 | 43 | ||
Stage 4 | 43 | ||
Stage 5 | 44 | ||
Screening and Diagnosis | 44 | ||
Timing of Screening | 44 | ||
Methods of Screening | 44 | ||
Prospective Future Markers | 49 | ||
Retinol-Binding Protein 4 | 49 | ||
Adiponectin | 49 | ||
Connective Tissue Growth Factor | 49 | ||
Urinary 1-Microglobulin | 50 | ||
Urinary Transforming Growth Factor-1 | 50 | ||
Liver-type Fatty acid Binding Protein | 50 | ||
Conclusion | 50 | ||
Non-Diabetic Glomerular Diseases in Diabetic Patients | 54a | ||
ABSTRACT | 54a | ||
KEYWORDS | 54b | ||
Introduction | 54 | ||
When to Suspect Non-Diabetic Glomerular Diseases in Diabetic Patients | 55 | ||
Types of Non-Diabetic Glomerular Diseases | 56 | ||
Differentiation of non-diabetic Glomerulonephritis from diabetic Nephropathy | 56 | ||
Mesangial-Proliferative Glomerulonephritis | 57 | ||
Minimal Change Nephropathy | 57 | ||
Differences between biopsy findings of glomerular lesions In non-diabetic glomerular diseases and diabetic nephropathy | 58 | ||
Occurrence and Pattern of glomerular lesions in Non-Diabetic glomerular diseases in diabetes mellitus | 59 | ||
Global Published Literature | 59 | ||
Indian published literature | 60 | ||
Unpublished Data from the Nizam's Institute of Medical Sciences | 61 | ||
Conclusion | 62 | ||
Nephrologic Problems Other Than Diabetic Nephropathy in Diabetes Mellitus | 64a | ||
ABSTRACT | 64a | ||
KEYWORDS | 64b | ||
Introduction | 64 | ||
Pathogenesis21 | 65 | ||
Urinary Tract Infections in Diabetes-Clinical Importance | 66 | ||
Urinary Tract Infections in Diabetes | 68 | ||
Asymptomatic bacteriuria | 68 | ||
Papillary Necrosis | 70 | ||
Emphysematous Pyelonephritis | 72 | ||
Xanthogranulomatous Pyelonephritis | 74 | ||
Renal Abscess | 74 | ||
Renal Cortical Abscess | 76 | ||
Renal Corticomedullary Abscess | 76 | ||
Perirenal Abscesses | 77 | ||
Fungal Infections | 78 | ||
Indian Experience | 78 | ||
Published Data From Nizam's Institute of Medical Sciences (Nims), Hyderabad | 79 | ||
Conclusion | 80 | ||
Acknowledgments | 80 | ||
Prevention of Diabetic Nephropathy | 85 | ||
Abstract | 85a | ||
Keywords | 85b | ||
Introduction | 85 | ||
Global Perspective | 87 | ||
United States Native Indian Health Service Diabetes Care | 87 | ||
Aboriginal Populations in Australia | 88 | ||
Aboriginal Populations in Canada | 89 | ||
Update in the Indian Context | 91 | ||
Kidney Help Trust of Chennai-A Model to Emulate | 93 | ||
Nipping in the Bud | 93 | ||
Strategies for Prevention of Diabetic Nephropathy | 94 | ||
DREAM Studies | 94 | ||
Disease Management Strategies | 96 | ||
Chronic Care Model | 97 | ||
Care Delivery Models | 97 | ||
Intervention strategies | 98 | ||
Monitoring and Measurement | 99 | ||
Prevention of Diabetic Nephropathy | 99 | ||
Preventing the Onset of Diabetes | 100 | ||
Preventing the Appearance of Diabetic Nephropathy | 101 | ||
Primary Prevention | 102 | ||
Secondary Prevention | 106 | ||
Multifactorial Intervention | 108 | ||
New Potential Therapeutic Strategies | 109 | ||
Conclusion | 110 | ||
Case Study | 116 | ||
Discussion and Rationale of Preventive Treatment | 116 | ||
Diabetic Nephropathy-Treatment Modalities | 119 | ||
Abstract | 119a | ||
Keywords | 119b | ||
Introduction | 119 | ||
The Indian Scenario of Diabetic Nephropathy | 120 | ||
Overview of Treatment | 120 | ||
Glycemic Control in Treatment of Diabetic Nephropathy | 121 | ||
Benefits of Glycemic Control | 121 | ||
Role of Pancreas Transplantation in Diabetic Nephropathy | 123 | ||
Choice of Medication and Dose Modification in Diabetic Chronic Kidney Disease Patients | 124 | ||
Blood Pressure Control in Diabetic Nephropathy | 124 | ||
Role of Blood Pressure Control in Treatment of Diabetic Nephropathy | 125 | ||
Choice of Antihypertensive Agents | 126 | ||
Blockade of the Renin-Angiotensin-Aldosterone System | 127 | ||
Management of Dyslipidemia in Diabetic Nephropathy | 132 | ||
Animal Model Studies | 132 | ||
Clinical Studies on Lipid Lowering Therapy | 133 | ||
Role of Dietary Protein Restriction | 134 | ||
Cardiovascular Risk Reduction | 134 | ||
Other Innovative Strategies | 135 | ||
InteGrated manaGement of dIabetIc nephropathy | 135 | ||
Conclusion | 135 | ||
Case Discussion | 143 | ||
Case 1: Case Presentation | 143 | ||
Management and Discussion | 145 | ||
case 2: case presentation | 148 | ||
Management and Discussion | 149 | ||
Management of End Stage Renal Disease in Diabetic Nephropathy | 151a | ||
Abstract | 151a | ||
Keywords | 151b | ||
Introduction | 151 | ||
Special Issues in Management of CKD in Diabetics | 152 | ||
Options of Renal Replacement | 154 | ||
Bidirectional Influence of Diabetic Comorbidities and Renal Replacement Therapy | 155 | ||
Influence of Comorbidities on Choice of Renal Replacement Therapy | 155 | ||
Influence of Dialysis on Various Diabetic Comorbidities | 157 | ||
Specific Problems in Diabetics who Undergo Renal Replacement Therapy | 157 | ||
Problems in Hemodialysis | 157 | ||
Vascular Access-Related Issues | 157 | ||
Hypotension27 | 161 | ||
Hypertension and Interdialytic Weight Gain28 | 161 | ||
Problems in Peritoneal Dialysis | 162 | ||
Peritonitis | 162 | ||
Metabolic Bone Disease33,34 | 162 | ||
Malnutrition35 | 162 | ||
Hyperglycemia | 163 | ||
Transplantation-Related Issues | 163 | ||
Cardiovascular Disease | 163 | ||
Evaluation for Cystopathy | 163 | ||
Evaluation for Other Complications | 163 | ||
Glycemic Control and Recurrence of Diabetic Nephropathy | 164 | ||
Comparison of Outcome in Different Renal Replacement Modalities | 164 | ||
Hemodialysis Versus Peritoneal Dialysis | 164 | ||
Transplantation and Survival | 165 | ||
Kidney-Pancreas Transplantation45 | 166 | ||
Surgical Issues47 | 166 | ||
Advantages of Pancreatic Transplantation48 | 167 | ||
Conclusion | 167 | ||
Indian Perspective of Diabetic Kidney Disease | 171 | ||
KEYWORDS | 171a | ||
Historical Perspective and Early Studies | 171 | ||
Chronic Renal Failure and Diabetes | 173 | ||
Morbidity and Mortality Due to Diabetic Nephropathy | 174 | ||
Need of Biomarkers for Nephropathy | 175 | ||
Urinary Albumin/Creatinine Ratio | 175 | ||
Genome-Wide analysis in diabetes with nephropathy | 176 | ||
DiabetOmics-Glycoproteome and Nephropathy | 177 | ||
Conclusion | 178 | ||
Acknowledgments | 178 | ||
Other Books in This Series | 180 |