Diabetic Nephropathy Differential Diagnoses

  • Author: Vecihi Batuman, MD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FACP, FASN   more...
 
Updated: Nov 23, 2011
 
 

Diagnostic Considerations

Diabetic nephropathy must be differentiated from cholesterol embolization, amyloidosis, and other glomerulopathies affecting patients with diabetes.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Vecihi Batuman, MD, FACP, FASN  Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology

Disclosure: Nothing to disclose.

Coauthor(s)

Rebecca J Schmidt, DO, FACP, FASN  Professor of Medicine, Section Chief, Department of Medicine, Section of Nephrology, West Virginia University School of Medicine

Rebecca J Schmidt, DO, FACP, FASN is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Nephrology, International Society of Nephrology, National Kidney Foundation, Renal Physicians Association, and West Virginia State Medical Association

Disclosure: Renal Ventures Ownership interest Other

Anjana S Soman, MD  Staff Physician, Department of Pathology, Quest Diagnostics

Anjana S Soman, MD is a member of the following medical societies: American Society for Clinical Pathology and College of American Pathologists

Disclosure: Nothing to disclose.

Sandeep S Soman, MBBS, MD, DNB  Senior Staff Physician, Department of Internal Medicine, Division of Nephrology and Hypertension, Henry Ford Hospital

Sandeep S Soman, MBBS, MD, DNB is a member of the following medical societies: American College of Physicians, American Medical Association, and American Society of Nephrology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

George R Aronoff, MD  Director, Professor, Departments of Internal Medicine and Pharmacology, Section of Nephrology, Kidney Disease Program, University of Louisville School of Medicine

George R Aronoff, MD is a member of the following medical societies: American Federation for Medical Research, American Society of Nephrology, Kentucky Medical Association, and National Kidney Foundation

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN  Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author T K S Rao, MD, FACP, to the development and writing of this article.

References

  1. Chiarelli F, Gaspari S, Marcovecchio ML. Role of growth factors in diabetic kidney disease. Horm Metab Res. Aug 2009;41(8):585-93. [Medline].

  2. Rask-Madsen C, King GL. Kidney complications: factors that protect the diabetic vasculature. Nat Med. Jan 2010;16(1):40-1. [Medline].

  3. de Boer IH, Rue TC, Hall YN, et al. Temporal trends in the prevalence of diabetic kidney disease in the United States. JAMA. Jun 22 2011;305(24):2532-9. [Medline].

  4. Pavkov ME, Bennett PH, Knowler WC, Krakoff J, Sievers ML, Nelson RG. Effect of youth-onset type 2 diabetes mellitus on incidence of end-stage renal disease and mortality in young and middle-aged Pima Indians. JAMA. Jul 26 2006;296(4):421-6. [Medline].

  5. Rosolowsky ET, Skupien J, Smiles AM, et al. Risk for ESRD in type 1 diabetes remains high despite renoprotection. J Am Soc Nephrol. Mar 2011;22(3):545-53. [Medline]. [Full Text].

  6. Kostadaras A. Risk Factors for Diabetic Nephropathy. Astoria Hypertension Clinic. Available at http://www.kidneydoctor.com/dm.htm.

  7. Iliadis F, Didangelos T, Ntemka A, et al. Glomerular filtration rate estimation in patients with type 2 diabetes: creatinine- or cystatin C-based equations?. Diabetologia. Dec 2011;54(12):2987-94. [Medline].

  8. Shlipak M. Diabetic nephropathy. Clin Evid (Online). Jan 14 2009;2009:[Medline].

  9. Burney BO, Kalaitzidis RG, Bakris GL. Novel therapies of diabetic nephropathy. Curr Opin Nephrol Hypertens. Mar 2009;18(2):107-11. [Medline].

  10. Suckling RJ, He FJ, Macgregor GA. Altered dietary salt intake for preventing and treating diabetic kidney disease. Cochrane Database Syst Rev. Dec 8 2010;12:CD006763. [Medline].

  11. Diabetes Control and Complications Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. The Diabetes Control and Complications (DCCT) Research Group. Kidney Int. Jun 1995;47(6):1703-20. [Medline].

  12. UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. Sep 12 1998;352(9131):837-53. [Medline].

  13. Mogensen CE. The effect of blood pressure intervention on renal function in insulin-dependent diabetes. Diabete Metab. 1989;15(5 Pt 2):343-51. [Medline].

  14. Diabetes Guidelines. Royal Free Hampstead NHS Trust. Available at http://royalfree.org.uk/default.aspx?top_nav_id=1&sel_left_nav=25&tab_id=403. Accessed 7/2/09.

  15. Laight DW. Therapeutic inhibition of the renin angiotensin aldosterone system. Expert Opin Ther Pat. Jun 2009;19(6):753-9. [Medline].

  16. Jennings DL, Kalus JS, Coleman CI, Manierski C, Yee J. Combination therapy with an ACE inhibitor and an angiotensin receptor blocker for diabetic nephropathy: a meta-analysis. Diabet Med. May 2007;24(5):486-93. [Medline].

  17. Imai E, Chan JC, Ito S, et al. Effects of olmesartan on renal and cardiovascular outcomes in type 2 diabetes with overt nephropathy: a multicentre, randomised, placebo-controlled study. Diabetologia. Dec 2011;54(12):2978-2986. [Medline].

  18. [Best Evidence] Persson F, Rossing P, Reinhard H, Juhl T, Stehouwer CD, Schalkwijk C, et al. Renal effects of aliskiren compared with and in combination with irbesartan in patients with type 2 diabetes, hypertension, and albuminuria. Diabetes Care. Oct 2009;32(10):1873-9. [Medline]. [Full Text].

  19. National Kidney Foundation. NKF-KDOQI Guidelines. Available at http://www.kidney.org/professionals/kdoqi/guidelines.cfm.

  20. Agarwal R. Vitamin D, proteinuria, diabetic nephropathy, and progression of CKD. Clin J Am Soc Nephrol. Sep 2009;4(9):1523-8. [Medline].

  21. de Zeeuw D, Agarwal R, Amdahl M, Audhya P, Coyne D, Garimella T, et al. Selective vitamin D receptor activation with paricalcitol for reduction of albuminuria in patients with type 2 diabetes (VITAL study): a randomised controlled trial. Lancet. Nov 6 2010;376(9752):1543-51. [Medline].

  22. [Best Evidence] Wenzel RR, Littke T, Kuranoff S, Jürgens C, Bruck H, Ritz E, et al. Avosentan reduces albumin excretion in diabetics with macroalbuminuria. J Am Soc Nephrol. Mar 2009;20(3):655-64. [Medline]. [Full Text].

  23. Suckling RJ, He FJ, Macgregor GA. Altered dietary salt intake for preventing and treating diabetic kidney disease. Cochrane Database Syst Rev. Dec 8 2010;12:CD006763. [Medline].

  24. Cooper ME. Pathogenesis, prevention, and treatment of diabetic nephropathy. Lancet. Jul 18 1998;352(9123):213-9. [Medline].

  25. Jacobsen P, Rossing K, Parving HH. Single versus dual blockade of the renin-angiotensin system (angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blockers) in diabetic nephropathy. Curr Opin Nephrol Hypertens. May 2004;13(3):319-24. [Medline].

  26. Matsuoka S, Awazu M. Masked hypertension in children and young adults. Pediatr Nephrol. Jun 2004;19(6):651-4. [Medline].

  27. Tanaka Y, Atsumi Y, Matsuoka K, Onuma T, Tohjima T, Kawamori R. Role of glycemic control and blood pressure in the development and progression of nephropathy in elderly Japanese NIDDM patients. Diabetes Care. Jan 1998;21(1):116-20. [Medline].

 
Previous
Next
 
Rate of decline in glomerular filtration rate in various stages of type 1 and type 2 diabetes.
Simple schema for the pathogenesis of diabetic nephropathy.
Screening for and prevention of the progression of microalbuminuria in diabetes mellitus. (ACE-I stands for angiotensin-converting enzyme inhibitor)
Stages in the development of diabetic nephropathy.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.