Patients with diabetes as viewed by clinical nephrologist

Authors: Vladimír Tesař ;  Jan Vachek ;  Oskar Zakiyanov
Authors‘ workplace: Klinika nefrologie 1. LF UK a Všeobecná fakultní nemocnice, Praha, Česká republika, prednosta prof. MUDr Vladimír Tesař, DrSc, MBA, FASN, FERA
Published in: Forum Diab 2015; 4(3): 162-165
Category: Foreign Post


Diabetic nephropathy is one of the frequent complications of diabetes while also being by far the most frequent cause of chronic renal failure which necessitates substitution of their function. Patients referred by diabetologists due to diabetic nephropathy – or suspicion of having it – make up, following ischemic nephropathy, the second largest part of the clientele of nephrology outpatient clinics. In the case of the confirmed diabetic nephropathy the nephrologist initiates comprehensive measures leading to slowing of the renal disease progression with the aim of delaying the necessary substitution of the kidney function as long as possible. An important differential dia­gnosis of diabetic nephropathy in particular involves the other glomerulopathies (primary or secondary), for which specific therapy is available. The distinguishing between diabetic nephropathy and coinciding glomerulopathy – or possibly another non-diabetic nephropathy – may not always be easy in practice and it requires careful assessment of anamnestic data, laboratory findings and, if needed, performance of renal biopsy. The aim of this report is to give a brief overview of the situations where a different illness should be considered for a diabetic patient, based on an atypical anamnesis, unusual course or different laboratory findings and which indicate a more detailed examination.Using the attached cases we want to demonstrate the conditions in relation to which the diagnosis of non-diabetic nephropathy led to a marked improvement of renal prognosis.

Key words:
chronic kidney disease (CKD) – diabetic nephropathy (DN) – diabetes mellitus (DM) – glomerulopathy – renal biopsy


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Diabetology Endocrinology Internal medicine
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