Histoire naturelle de la néphropathie diabétique

Diabetic nephropathy has become the leading cause of entry into dialysis in Europe, and the cardiovascular risk associated with each successive stage renal disease (glomerular hyperfiltration, micro-albuminuria, macro-albuminuria, renal failure) is even higher than the renal risk. All patients with diabetes are not at risk of severe kidney disease, a genetic predisposition has been identified and partially unraveled. Other risk factors for progression of renal disease include the number of nephrons at birth, possibly altered in case of adverse fetal environment, hypertension, smoking, certain lipid abnormalities, and of course hyperglycemia. The level of proteinuria is a prognostic factor and also a therapeutic target.