Risk factors for Diabetic Nephropathy

Abstract

Diabetic nephropathy (DN) is a public health problem whose prevalence is constantly increasing, it represents a significant economic, social and health burden, its diagnosis is usually late and not routine. Early and timely diagnosis slows disease progression, improves quality of life, increases life expectancy, and reduces high costs of care. It is characterized by elevated urinary albumin excretion (≥30 mg / g urinary creatinine) and / or estimated glomerular filtration rate <60 ml / min / 1.73 m2. The pathophysiology of DN is complex, determined by persistent hyperglycemia, and includes renal hemodynamic changes, spinal ischemia, tissue inflammation, and activation of the renin-angiotensin-aldosterone system. Among the non-modifiable risk factors associated with DN are gender, chronological age, age at diagnosis of DM2, duration of DM2, family history of DN, ethnicity and genetic factors. Among the modifiable poor prognostic factors for DN, the modifiable risk factors for DN are diabetes education, smoking, high glycosylated hemoglobin levels, arterial hypertension, dyslipidemia, abdominal obesity, and bad prognostic factors would be anemia. retinopathy, neuropathy, and elevated uric acid levels. A review of the literature of the factors associated with DN is carried out and the importance of its early and timely diagnosis is emphasized.