* * *
- Balkan n. interstitial chronic nephritis of unknown etiology, originally described as a disease endemic in the Balkans, characterized by insidious onset, scanty urinary findings, anemia, and acidosis. SYN: Danubian endemic familial n..
- diabetic n. a syndrome occurring in people with diabetes mellitus and characterized by albuminuria, hypertension, and progressive renal insufficiency.Diabetic n. is a major cause of morbidity and mortality in people with diabetes mellitus (DM). People with diabetes make up the largest number (>25%) of those who start renal dialysis for end-stage renal disease (ESRD) each year in the U.S. The incidence of ESRD approaches 40% in people who have had type 1 DM for 20 years. The risk of diabetic n. is higher in males, blacks, Hispanics, and Native Americans. Within 3 years after the diagnosis of DM is made, histologic study shows thickening of glomerular basement membrane and mesangial expansion, changes characteristic of diabetic glomerulosclerosis (Kimmelstiel-Wilson disease). The kidneys increase in size and weight because of both hypertrophy and hyperplasia of parenchymal cells, and renal blood flow and glomerular filtration rate (GFR) are increased; as a result, serum creatinine and urea nitrogen are slightly reduced. After 10–15 years, the first evidence of renal damage may appear as microalbuminuria, a persistent excretion of albumin in concentrations not detected by routine tests for urinary protein. An albumin excretion rate of 20–200 μg/min (30–300 mg/day) heralds the onset of diabetic n. and strongly predicts eventual ESRD. Further progression of renal damage leads to frank albuminuria and a decline in glomerular filtration rate and nitrogen clearance. The prevalence of hypertension is markedly greater in persons with microalbuminuria, and hypertension accelerates the progression of renal disease. Diabetic n. can lead to hyperkalemia, metabolic acidosis, nephrotic syndrome, papillary necrosis, and increased susceptibility to acute renal failure after exposure to radiographic contrast media. Current practice guidelines for the treatment of DM call for annual assessment of 24-hour albumin excretion, prompt treatment of urinary tract infections, and avoidance of nephrotoxic drugs and radiographic dyes. No interventions have been shown to reverse clinical diabetic n.. However, prospective randomized studies have established that improved metabolic control, maintaining plasma glucose as near normal as possible at all times, can markedly decrease the development and progression of diabetic n., as well as of other long-term microvascular complications of diabetes (retinopathy and neuropathy). In addition, aggressive management of hypertension with ACE inhibitors or angiotensin II receptor blockers has been shown to delay progression of n. by mechanisms independent of blood pressure control, and limitation of daily protein intake to 0.8 g/kg of body weight (not appropriate in pregnancy) has been shown to delay progression of both diabetic and nondiabetic renal disease. ESRD is treated with kidney transplantation, hemodialysis, or peritoneal dialysis. Because diabetic retinopathy and neuropathy progress more rapidly with the onset of renal failure, dialysis is usually instituted early (when serum creatinine reaches about 6 mg/dL) in diabetic n..
- hypokalemic n. vacuolation of the epithelial cytoplasm of renal convoluted tubules in patients seriously depleted of potassium; vacuoles do not contain fat or glycogen, concentrating ability is impaired, polyuria and polydipsia are common, and pyelonephritis may develop. SYN: vacuolar nephrosis.
- IgA n. SYN: focal glomerulonephritis.
- IgM n. SYN: mesangial proliferative glomerulonephritis.
* * *
ne·phrop·a·thy ni-'fräp-ə-thē n, pl -thies an abnormal state of the kidney esp one associated with or secondary to some other pathological process
neph·ro·path·ic .nef-rə-'path-ik adj
* * *
n.
* * *
ne·phrop·a·thy (nə-fropґə-the) [nephro- + -pathy] any disease of the kidneys; see also nephritis. Called also nephrosis. nephropathic adjMedical dictionary. 2011.