NEPHROPATHY IN TYPE-1 DIABETES - THE ROLE OF GENETIC-FACTORS

Diabetic nephropathy affects up to 30 % of all patients with Type 1 (i nsulin-dependent) diabetes and is associated with a high morbidity and mortality. A number of studies have suggested that, unlike retinopath y or neuropathy, the influence of hereditary factors on the developmen t of nephropathy is strong. Much interest has focused on possible gene tic markers indicating an increased risk for developing diabetic nephr opathy. it is envisaged that patients with Type 1 diabetes may be scre ened at diagnosis for increased susceptibility to nephropathy and subs equently have intensified follow up and possibly even prophylactic the rapy in order to prevent progression to nephropathy. Two groups of can didate genes have so far been of particular interest: those implicated in the aetiology of hypertension, and those involved in the metabolis m of glomerular basement membrane proteins. This article aims to revie w the evidence suggesting a role for hereditary factors, possible gene tic models, and the genetic loci thought to be involved.