DIABETIC NEPHROPATHY - ETIOPATHOGENESIS, CLINICAL MANIFESTATION, AND THERAPY

An account is given in this review paper of topical aspects relating to diagnosis, prevention, and treatment of diabetic nephropathy. Emphasis was laid on an analysis of the strategy of conservative therapy. Prevention of diabetic nephropathy has proved to depend strongly on adequate metabolic compensation. Hypertension was found to grow manifest as early as in the phase of incipient diabetic nephropathy. Decline in renal function is calculable and can be stopped with significance of stringent blood pressure adjustment. Measures by which to avoid overhydration and hypertensive blood pressure derailment deserve highest priority in coping with renal insufficiency. Dietary protein restriction ist indicated in response to incipient renal insufficiency. Good care of diabetics with renal insufficiency depends strongly on smooth interdisciplinary action and properly timed assurance of active care (dialysis/kidney transplantation).