Causese of Diabetic nephropathy

Diabetic nephropathy is caused by different causes and onset mechanism of insulin in the absolute and the relative lack of that sugar, protein and fat metabolism disorders, chronic high blood sugar, the main clinical manifestations of systemic disease. Can diabetes damage the kidneys of those damages by different means involving the kidney structure, but only glomerular sclerosis and diabetes, also known as diabetic nephropathy, is one of the microvascular complications of diabetes systemic. Diabetic patients in the event of kidney damage persistent urinary protein, the disease is irreversible tend to develop to the end-stage renal failure. Diabetic nephropathy has become the leading cause of death in diabetic patients.
Diabetic nephropathy is more common in patients with diabetes duration of more than 10 years of proteinuria is the earliest manifestations of diabetic nephropathy, the onset mechanism is very complex, yet completely clarified. The research data show that the onset mechanism of diabetic nephropathy is multifactorial, mainly in the following areas:
1, the renal hemodynamic abnormalities
Play a key role in diabetic nephropathy, and may even be the initiating factor.
(1) hyperglycemia, glomerular hyperperfusion, hyperfiltration state, across the capillary wall pressure, so that the expansion of mesangial cells, epithelial cell foot process fusion and produce dense droplets, glomerular epithelial cells from off on the basement membrane. (2) the glomerular basement membrane collagen type Ⅳ messenger sugar nucleic acid increased basement membrane thickening, the final form of diffuse mesangial nodular lesions, the occurrence of glomerular sclerosis.
(3) In the case of pressure, increased protein filtration can also be deposited in the mesangium and glomerular basement membrane, promoting stromal proliferation constitute a vicious cycle, and can cause nodular and diffuse glomerular sclerosis.
2, hyperglycemia
Diabetic nephropathy is closely related to high blood sugar, poor blood sugar control can accelerate the occurrence and development of diabetic nephropathy good glucose control clearly slow down the development. Hyperglycemia and advanced glycation end products increased production caused by the proliferation of mesangial cells increase extracellular matrix, mesangial expansion, glomerular basement membrane thickening.
3, genetic factors
Most diabetic patients eventually kidney disease does not occur, the same, there may be some good long-term glycemic control in patients with diabetic nephropathy. Glucose transporter protein -1 (GLUT1) is the major glucose transporter in mesangial cells. Recent studies have found that diabetic patients from different individuals mesangial cell GLUT1 menu of the differences in the regulation may be one of the factors of some patients susceptible to kidney damage. And diabetic nephropathy also showed family aggregation in some family history of hypertension in diabetic patients, the incidence of diabetic nephropathy is also significantly higher in patients without hypertension, family history. In addition, the incidence of diabetic nephropathy between the different races there are also differences. That show the occurrence of diabetic nephropathy and genetic factors.
4, high blood pressure
With diabetic nephropathy are not directly related to microalbuminuria urine protein of the blood pressure can accelerate the progress of diabetic nephropathy and deterioration of renal function, increased urinary albumin excretion of the original high blood pressure or duration.