What Causes Diabetic Nephropathy

Diabetic nephropathy is a type of progressive kidney disease that occurs in people who have diabetes. Diabetic nephropathy progresses slowly. Then, what causes diabetic nephropathy?

Each of your kidneys has about one million nephrons. Nephrons are small structures that filter waste from your blood. Diabetes can cause the nephrons to thicken and scar, which makes them less able to filter waste and remove fluid from the body. This causes them to leak a type of protein called albumin into your urine, leading to diabetic nephropathy.

The exact reason this occurs in people with diabetes is unknown, but high blood sugar levels and high blood pressure are thought to contribute to diabetic nephropathy. Persistently high blood sugar or blood pressure levels are two things that can damage your kidneys, making them unable to filter waste and remove water from your body.

Other factors have been shown to increase your risk of getting diabetic nephropathy, such as:
· being African-American, Hispanic, or American Indian
· developing type 1 diabetes before you are 20 years old
· smoking


Certain things make you more likely to get diabetic nephropathy. If you also havehigh blood pressure or high cholesterol, or if you smoke, your risk is higher. Also, Native Americans, African Americans, and Hispanics (especially Mexican Americans) have a higher risk.

The reasons of diabetic nephropathy

Diabetic nephropathy results from diabetes,which is the second reason forming end-stage renal disease, and it ranks only second to the glomerulonephritis.As complicated metabolic disorders,once it develops into end-stage renal disease,its treatment will be more troublesome than other kidney diseases.So it is important to treat diabetes timely.

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.