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Clinical Approach to Renal Diseases in Diabetes

Clinical Approach to Renal Diseases in Diabetes


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International Edition


About the Book

?Written in simple and vivid language.
?Contains 12 chapters on Diabetes Mellitus and its renal afflictions in a stepwise manner.
?Provides a comprehensive and systematic review on all the components of the complex relationship between ‘diabetes’ and ‘kidney’.
?Contains a detail discussion on treatment of diabetes, associated hypertension, dyslipidemia and antiproteinuric measures.
?Role of renin-angiotensin-aldosterone system (RAAS) inhibition is emphasised.
?The importance of lifestyle modification in controlling diabetes mellitus has been explained.
?Descriptive illustrations and tabulated information make the book visually appealing.
?Provides theoretical and practical information both evidence and experience based.
?Extensive literature references add to the value of the book’s content.

About the Author

T Dhinakaran MBBS MD (Gen Med) MNAMS (Gen Med) DM (Neph)



Table of Contents:
Contents 1. Diabetes Mellitus—A Worldwide Health Challenge 1 T Dhinakaran, Suganya Sivakumar The Indian scenario 1 Reasons behind the rising trend in Indians 2 Prevention of type 2 diabetes—some useful steps 5 What is our progress? 8 2. Diabetes and Kidney—Diabetic Kidney Disease 12 T Dhinakaran The terminology 13 Indian studies showing incidence of complications of diabetes 14 Clinical stages of diabetic glomerulopathy 14 3. Risk Factors for Diabetic Nephropathy 19 T Dhinakaran Risk factors for diabetic nephropathy 19 4. Is Diabetic Nephropathy Preventable? 31 T Dhinakaran The early clinical course of diabetic nephropathy 31 Prevention of microalbuminuria: renin-angiotensin system—inhibitor therapy 32 New in preventive strategies—role of biomarkers in diabetic nephropathy 36 5. Pathophysiology of Diabetic Nephropathy 41 T Dhinakaran, M Sivakumar Polyol pathway 42 Hexosamine pathway 43 Advanced glycation end products 44 Activation of protein kinase C 46 Renin-angiotensin-aldosterone systems and diabetic nephropathy 48 Endothelial dysfunction in diabetic nephropathy 49 Podocyte pathophysiology in diabetic nephropathy 55 Transforming growth factor beta: is it the common downstream mediator of diabetic nephropathy? 56 Pathology of kidney disease in diabetes mellitus 56 Diabetic nephropathy—pathologic classification 58 6. Microalbuminuria in Diabetic Nephropathy—A Marker or a Risk Factor? 64 T Dhinakaran, V Chiranjeevi, D Nithya Microalbuminuria—what is it? 64 The incidence and course in diabetic nephropathy 65 Limitations of microalbuminuria 66 xiv Clinical Approach to Renal Diseases in Diabetes Screening 67 Techniques of measuring 67 How to treat microalbuminuria? 68 7. Diabetic Nephropathy—Treatment: Hyperglycemia Control 78 T Dhinakaran, M Sivakumar Glycemic control 79 Insulin and insulin analogs 96 8. Diabetic Nephropathy—Treatment: Hypertension and Proteinuria Therapy 106 T Dhinakaran, M Sivakumar Recommendation on target blood pressure 107 Hypertension therapy 108 The renin-angiotensin-aldosterone system in diabetic nephropathy 108 9. Diabetic Nephropathy—Other Therapies for Improving Renal Outcome 131 T Dhinakaran Protein restriction 132 Salt intake 132 Weight reduction 133 Lipid management and statin therapy 133 Anemia in diabetes: its role and relevance in diabetic kidney disease progression 135 Newer therapeutic approaches 138 Receptor for advanced glycation end products and the pathogenesis of chronic kidney disease 143 Endothelin antagonism for diabetic nephropathy 144 Role of angiotensin-converting enzyme and degradation of angiotensin ii 146 Vitamin D in diabetic nephropathy 147 Anti-inflammatory therapy 148 10. Diabetes and Kidney—“Beyond Nephropathy” 155 T Dhinakaran, Suganya Sivakumar Urinary tract infections 155 Bacteria 157 Viruses 157 Fungi 158 Tuberculosis 158 Pyelonephritis 158 Renal papillary necrosis 160 Renovascular disease in diabetic patients 161 Diabetic autonomic neuropathy 165 Renal tubular acidosis (type-4 rta) 168 Contrast nephropathy 168 Ketoacidosis and kidney 168 Development of renal disease in diabetic ketosis 171 xv 11. Diabetic Nephropathy and Cardiovascular Morbidity 175 T Dhinakaran Proteinuria glomerular filtration rate and cardiac risk 177 Hyperglycemia 180 Other risk factors 180 Major mechanisms responsible for the high cardiovascular disease risk in diabetic nephropathy: summary 184 Nontraditional risk factors 185 Therapeutic considerations including future treatments 189 12. Diabetic End Stage Renal Disease—Is there Light at the End of the Tunnel? 196 T Dhinakaran, P Soundararajan Management options 196 Blood pressure/sugar control in diabetic end stage renal disease 198 Glycemic control 200 Special consideration for hemodialysis in diabetes 201 Continuous ambulatory peritoneal dialysis 202 Transplantation in diabetes 209 Management of diabetic end stage renal disease patients after kidney transplantation 210 Pancreas and kidney transplantation 213 Management of failing graft and retransplantation in diabetic patients 214 Index 221 Contents


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Product Details
  • ISBN-13: 9789351525721
  • Publisher: Jaypee Brothers Medical Publishers
  • Binding: HARDCOVER
  • Edition: 1
  • Language: English
  • Returnable: Y
  • Weight: 680 gr
  • ISBN-10: 9351525724
  • Publisher Date: 20 Mar 2015
  • Depth: 19
  • Height: 170 mm
  • No of Pages: 226
  • Spine Width: 16 mm
  • Width: 252 mm


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Clinical Approach to Renal Diseases in Diabetes
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