1. Renal hemodynamic abnormalities
In the early stage of diabetic nephropathy we can observe renal hemodynamic abnormalities,and it can show glomerular high perfusion,high filtration,the rise of renal blood flow, glomerular filtration rate,meanwhile it will increase more quickly after absorbing protein.
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2.Hyperglycemia causing metabolic disturbance
Hyperglycemia is caused by the change of renal hemodynamics,and metabolic disorders lead to kidney damage. The mechanism of metabolic disorders leading to kidney damage including:kidney local sugar metabolic disorder, it can by non-enzymatic glycation forming AGES, the activation of polyol pathway, the activation of diacylglycerol-protein kinase c,having sugar amine pathway metabolic abnormalities.
3.Hypertension
Almost every diabetic nephropathy patients with the symptoms of hypertension, in type 1 diabetic nephropathy, hypertension and microalbuminuria happen parallelly, but it will appear before diabetic nephropathy happens in type 2 diabetic nephropathy. It is closely related to control blood pressure and the development of diabetic nephropathy.
4.Vascular active substances metabolic abnormalities
The development process of diabetic nephropathy will show vascular active substances metabolic abnormalities, and it includes the metabolic disorder of RAS,ET, prostaglandins, growth factors.
5.Genetic factors
The proportion of diabetic nephropathy is higher in male than female. 40%-50% type 1 diabetes patients will show the symptoms of microalbuminuria, and about 20%-30% type 2diabetes patients will develop into diabetic nephropathy. All of above indicates that genetic factors play a important role in diabetic nephropathy.
