Prevalence and Incidence of Diabetic Nephropathy
Diabetic Nephropathy Prevalence: Book Excerpts
Prevelance of Diabetic Nephropathy discussion:
Diabetic kidney disease is the most common cause of kidney failure in
the United States and the greatest threat to life in adults with type 1
diabetes. After having diabetes for 15 years, one-third of people with
type 1 diabetes develop kidney disease. Diabetes damages the small blood
vessels in the kidneys, impairing their ability to filter impurities from
blood for excretion in the urine. Persons with kidney damage must have a
kidney transplant or rely on dialysis to cleanse their blood. (Source: excerpt from Diabetes Control and Complications Trial (DCCT): NIDDK)
Prevalence/Incidence of Diabetic Nephropathy: Online Medical Books
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for more information about the prevalence and/or incidence of Diabetic Nephropathy.
Acute pyelonephritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Acute pyelonephritis results from bacterial infection of the kidneys. Infecting bacteria usually are normal intestinal and fecal flora that grow readily in urine. The most common causative organism is Escherichia coli, but Proteus, Pseudomonas, Staphylococcus aureus, and Enterococcus faecalis (formerly Streptococcus faecalis) may also cause this infection.
Typically, the infection spreads from the bladder to the ureters, then to the kidneys, as in vesicoureteral reflux due to congenital weakness at the junction of the ureter and the bladder. Bacteria refluxed to intrarenal tissues may create colonies of infection within 24 to 48 hours. Infection may also result from instrumentation (such as catheterization, cystoscopy, or urologic surgery), from a hematogenic infection (as in septicemia or endocarditis), or possibly from lymphatic infection.
Pyelonephritis may also result from an inability to empty the bladder (for example, in patients with neurogenic bladder), urinary stasis, or urinary obstruction due to tumors, strictures, or benign prostatic hyperplasia.
Pyelonephritis occurs more commonly in females, probably because of a shorter urethra and the proximity of the urinary meatus to the vagina and the rectum — both conditions allow bacteria to reach the bladder more easily — and a lack of the antibacterial prostatic secretions produced in the male. Incidence increases with age and is higher in the following groups:
❑ Sexually active females: Intercourse increases the risk of bacterial contamination.
❑ Pregnant females: About 5% develop asymptomatic bacteriuria; if untreated, about 40% develop pyelonephritis.
❑ Diabetics: Neurogenic bladder causes incomplete emptying and urinary stasis; glycosuria may support bacterial growth in the urine.
❑ Persons with other renal diseases: Compromised renal function aggravates susceptibility.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Nephrotic syndrome:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
About 75% of nephrotic syndrome cases result from primary (idiopathic) glomerulonephritis. Classifications include:
❑ In lipid nephrosis (nil lesions), the main cause of nephrotic syndrome in children, the glomerulus looks normal by light microscopy. Some tubules may contain increased lipid deposits.
❑ Membranous glomerulonephritis, the most common lesion in adult idiopathic nephrotic syndrome, is characterized by uniform thickening of the glomerular basement membrane containing dense deposits and eventually progresses to renal failure.
❑ Focal glomerulosclerosis can develop spontaneously at any age, follow renal transplantation, or result from heroin abuse. Reported incidence of this condition is 10% in children with nephrotic syndrome and up to 20% in adults. Lesions initially affect the deeper glomeruli, causing hyaline sclerosis, with later involvement of the superficial glomeruli. These lesions generally cause slowly progressive deterioration in renal function. Remissions occur occasionally.
❑ In membranoproliferative glomerulonephritis, slowly progressive lesions develop in the subendothelial region of the basement membrane. Lesions may follow infection, particularly streptococcal infection. This disease occurs primarily in children and young adults.
Other causes of nephrotic syndrome include metabolic diseases such as diabetes mellitus; collagen-vascular disorders, such as systemic lupus erythematosus and periarteritis nodosa; circulatory diseases, such as heart failure, sickle cell anemia, and renal vein thrombosis; nephrotoxins, such as mercury, gold, and bismuth; allergic reactions; and infections, such as tuberculosis or enteritis. Other possible causes are pregnancy, hereditary nephritis, multiple myeloma, and other neoplastic diseases. These diseases increase glomerular protein permeability, leading to increased urinary excretion of protein, especially albumin, and subsequent hypoalbuminemia.
Nephrotic patients have an increased risk of infection, particularly of peritonitis.
PEDIATRIC TIP Black children appear to be at greater risk for peritonitis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
About prevalence and incidence statistics:
The term 'prevalence' of Diabetic Nephropathy usually refers to the estimated population
of people who are managing Diabetic Nephropathy at any given time.
The term 'incidence' of Diabetic Nephropathy refers to the annual diagnosis rate,
or the number of new cases of Diabetic Nephropathy diagnosed each year.
Hence, these two statistics types can differ:
a short-lived disease like flu can have high annual incidence but low prevalence,
but a life-long disease like diabetes has a low annual incidence but high prevalence.
For more information see about prevalence and incidence statistics.
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