The factors that form diabetes are as follows:
First, genetic factors
Most patients with diabetes will eventually not have kidney disease, but some patients with good long-term glycemic control may also have diabetic nephropathy, mainly due to the formation of major glucose transporters on mesangial cells.
Second, high blood sugar factors
Most diabetic nephropathy is closely related to hyperglycemia. When the patient's blood sugar control is poor, hyperglycemia and glycosylation end product production increase, causing mesangial cell proliferation, extracellular matrix, mesangial expansion, The glomerular basement membrane is thickened, etc., thereby promoting the occurrence of diabetic nephropathy.
Third, the factors of hypertension
Although there is no direct relationship between hypertension and diabetic nephropathy, the increase in blood pressure during the microalbuminurial period of the original hypertension course can accelerate the deterioration of renal function in patients with diabetic nephropathy, thereby inducing diabetic nephropathy.
Fourth, renal hemodynamic abnormal factors
Renal blood flow factors play a very important role in the development of diabetic nephropathy, and may be a starting factor. The specific analysis is generally carried out from the following four situations:
1. When hyperglycemia, the capillary wall pressure increases, promotes the expansion of mesangial cells, the epithelial cell foot processes fuse and produce dense droplets, and the glomerular epithelial cells fall off the basement membrane, resulting in high perfusion in the glomerulus. High filtration state.
2, glomerular basement membrane type IV collagen messenger nucleic acid increased, to thicken the basement membrane, and finally form a diffuse, nodular lesion of the mesangium, resulting in glomerular sclerosis.
3. In the case of increased renal blood flow pressure, protein filtration increases, promotes matrix augmentation, forms mesangial area and glomerular basement membrane, leading to nodular glomerular sclerosis.
