THE DIABETIC PATIENT WITH HYPERTENSION AN D NEPHROPATHY

About 40% of diabetic patients are threatened by nephropathy in the lo ng-term course of their disease. 90% of diabetic patients with nephrop athy are hypertensive. Hypertension is a major cause for progression o f nephropathy. The increased cardiovascular mortality and morbidity of diabetes form a cluster in diabetic patients with nephropathy. The fi rst clinically relevant stage of nephropathy that can be early diagnos ed is microalbuminuria with albuminuria between 30 and 300 mg/day. In this stage near-normal blood glucose control and optimal treatment of hypertension can halt the progression of nephropathy. Conventional dip stick-positive proteinuria is indicator of an advanced stage of nephro pathy, that leads to chronic renal failure and dialysis or early morta lity within an average period of ten years unless there is adequate tr eatment of hypertension.