The Kidney and Hypertension in Diabetes Mellitus

The first sporadic observations describing renal abnormalities in diabetes were published late in the 19th century, but systematic studies of the kidney in diabetes started only half a century ago after the paper by Cambier in 1934 and the much more famous study by Kimmelstiel and Wilson in 1936. These authors described two distinct features of renal involvement in diabetes: early hyperfiltration and late nephropathy. Diabetic nephropathy is, despite half a century of studies, still a very pertinent problem, renal disease in diabetes now being a very common cause of end-stage renal failure in Europe and North America and probably throughout the world. It is a very important part of the generalized vascular disease found in long-term diabetes as described by Knud Lundbaek in his mono graph Long-term Diabetes in 1953, published by Munks gaard, Copenhagen. Surprisingly, there has not been a comprehensive volume describing all aspects of renal involvement in diabetes, and the time is now ripe for such a volume summarizing the very considerable research activity within this field during the last decade and especially during the last few years. This book attempts to cover practically all aspects of renal involvement in diabetes. It is written by colleagues who are themselves active in the many fields of medical research covered in this volume: epidemiology, physiology and pathophysiology, laboratory methodology, and renal pathology. New studies deal with the dia gnosis and treatment of both incipient and overt nephropathy by metabolie, antihypertensive, and dietary invention.

Zusammenfassung
`This is a timely publication that will be welcomed by all clinicians ... covers all aspects of diabetic nephropathy, from epidemiology to pathophysiology and management. ... clear and concise ... This should be essential reading for all nephrologists and will find a place in the libraries of all renal units managing patients with end-stage renal failure.'
Nephrology/Dialysis, 5/6

Inhalt
1 From beta cell impairment and destruction to multiple organ lesions in diabetes: extent of the problem.- 2 Definition of diabetic renal disease in insulin-dependent diabetes mellitus, based on renal function tests.- 3 Epidemiology of renal involvement in diabetes mellitus.- 4 Population comparisons of the frequency of diabetic nephropathy.- 5 Incidence of nephropathy in insulin-dependent diabetes as related to mortality.- 6 Microalbuminuria: an appraisal of assay techniques and urine collection procedures for measuring urinary albumin at low concentrations.- 7 Prevalence of microalbuminuria in the diabetic clinic.- 8 Prevalence and incidence of microalbuminuria in non-insulin-dependent diabetes: relations to other vascular lesions.- 9 Microalbuminuria and mortality in non-insulin-dependent diabetes.- 10 Light microscopy of diabetic glomerulosclerosis: classic lesions and differential diagnosis.- 11 Hematuria and diabetic nephropathy.- 12 The ultrastructure of diabetic nephropathy in type 1 (insulin-dependent) diabetes: structural and functional relationships and determinants of prognosis.- 13 Glomerular structural changes in diabetes mellitus.- 14 The renal tubules in experimental diabetes.- 15 Pathogenesis of diabetic glomerulopathy: a biochemical view.- 16 Blood fluids and blood pressure in diabetes, with and without nephropathy.- 17 Pathogenesis of diabetic glomerulopathy: the role of glomerular hyperfiltration.- 18 Renal involvement and diabetic nephropathy in diabetic children.- 19 Early renal hyperfunction and hypertrophy in insulin-dependent patients: changes found at diagnosis and early in the course of diabetes.- 20 The concept of incipient diabetic nephropathy and the longitudinal course of microalbuminuria: effect ofantihypertensive intervention.- 21 Acutemodulation of renal function in microabuminuric and macroalbuminuric insulin-dependent diabetic patients.- 22 Hypertension in diabetics with renal disease.- 23 The course of renal function before and during antihypertensive treatment in diabetic nephropathy.- 24 The course of incipient and overt diabetic nephropathy: the perspective of insulin pump treatment.- 25 Nonglycemic intervention in diabetic nephropathy: the role of dietary protein intake.- 26 Urinary tract infection and diabetes: diagnosis and treatment.- 27 Microalbuminuria and diabetic pregnancy.- 28 Diabetic nephropathy and pregnancy.- 29 Acute renal failure in diabetics.- 30 Contrast media induced nephropathy in diabetic nephropathy.- 31 Renal papillary necrosis in diabetic patients.- 32 Diabetic cystopathy.- 33 Progression and nonprogression of chronic renal failure in diabetic nephropathy: which factors are determinants?.- 34 Problems related to the start of end-stage renal failure treatment in diabetic patients with advanced nephropathy.- 35 Concomitant organ lesions: diabetic retinopathy in early and advanced nephropathy.- 36 The heart in diabetes in early and advanced nepnropathy.- 37 Diabetic neuropathy, vascular disease, and the foot in diabetic nephropathy.- 38 Hemodialysis in type 1 and type 2 diabetic patients with end-stage renal failure.- 39 Continuous ambulatory peritoneal dialysis in uremic diabetics.- 40 Renal transplantation in diabetic patients: the treatment of choice.- 41 Immunosuppressive therapy for diabetics after renal transplantation.- 42 Renal transplantation combined with pancreas transplantation: is there a clinical indication?.- 43 Evolution of the treatment of patients with diabetic nephropathy by renal replacement therapy in Europe over a decade: data from the EDTA registry.- 44 Aspects of insulin treatment in uremic insulin-dependent diabetic patients before and after active replacement therapy.- 45 Diabetic nephropathy in the third world.- 46 Recurrence of diabetic nephropathy in renal transplants.- 47 Concerns in planning studies of diabetic nephropathy.