DIABETIC NEPHROPATHY IN TYPE-II DIABETES

The incidence of end-stage renal failure in patients with type II diab etes has dramatically increased in recent years, both in the United St ates and, with some delay, in some European countries, These epidemiol ogic observations have thoroughly dispelled the mistaken belief that r enal prognosis was benign in type II diabetes, Recent interest has foc used on the early stages of nephropathy in type II diabetes, With resp ect to renal hemodynamics, renal morphology, and progression of establ ished diabetic nephropathy, there are no substantial differences betwe en types I and type II diabetes, There is good evidence that preventiv e measures are effective, ie, glycemic control, blood pressure control , protein restriction, and discontinuation of smoking, The high preval ence of the disease (which in principle is preventable) calls for inte nse efforts to (1) educate the medical community, (2) substantially im prove patient education and medical care, and (3) intensify research i n this field. (C) 1996 by the National Kidney Foundation, Inc.