Pathogenesis of diabetic nephropathy

From the surface meaning is concerned, many of my friends will think there is a diabetes-induced diabetic nephropathy, in fact, diabetes is just one cause of the disease. Diabetic nephropathy is one of the complications of diabetes, but the patient was diabetic nephropathy, but not just because of this, the pathogenesis of diabetic nephropathy, there are many reasons, which are very worth to explore. Listed below are a few common causes:

1, genetic factors

Most diabetic kidney disease does not occur eventually, some long-term good glycemic control in patients with diabetic nephropathy also can occur. Glucose transporter protein -1 (GLUT1) is on mesangial cells mainly glucose transporter. Diabetic nephropathy also showed family aggregation, family history of hypertension in some patients with diabetes, the incidence of diabetic nephropathy was significantly higher than in patients without family history of hypertension. In addition, inter-ethnic incidence of diabetic nephropathy there are differences. This indicates that both the incidence of diabetic nephropathy and genetic factors.

2, high blood pressure

And diabetic nephropathy has no direct relationship, but the course of pre-existing hypertension or microalbuminuria to elevated blood pressure can accelerate the progress of diabetic nephropathy after and deterioration of renal function, increased urinary albumin excretion.

3, hyperglycemia

Diabetic nephropathy is closely related with high blood sugar, poor blood sugar control can accelerate the development of diabetic nephropathy, good blood glucose control can significantly slow down its development. High blood sugar and glycation endproducts increase induced mesangial cell proliferation, extracellular matrix increased mesangial expansion, glomerular basement membrane thickening.

4, renal hemodynamic abnormalities

In diabetic nephropathy, to play a key role, and may even be the initial factor.

(1) hyperglycemia, glomerular hyperperfusion, hyperfiltration state, increased pressure across the capillary wall, so that the expansion of mesangial cells, epithelial cell foot process fusion and produce dense droplets, glomerular epithelial cells from the basal membrane shedding.

(2) the glomerular basement membrane collagen Ⅳ messenger sugar nucleic acid increased, the basement membrane thickening, and ultimately the formation of mesangial diffuse, nodular lesions, occurred glomerulosclerosis.

(3) In the case of increased pressure, increased protein filtration can also be deposited in the mesangial area and glomerular basement membrane, promoting stromal proliferation, creating a vicious cycle, and can cause nodular and diffuse glomerulosclerosis .

It can be seen, the causes of diabetic nephropathy is associated with diabetes has a direct relationship, but its causes Quefei there is only this one, the patient's condition is also associated with other possibilities, the several factors, but also are common causes of diabetic nephropathy.