NEPHROPATHY OF TYPE-II DIABETES-MELLITUS

In recent years there has been a dramatic increase of almost epidemic proportions in the incidence of patients with type II diabetes mellitu s who reach end-stage renal failure and enter renal replacement progra mmes. This is mainly due to the greater prevalence and better survival of patients with type II diabetes and diabetic nephropathy. Against t his background measures to prevent the appearance and progression of d iabetic nephropathy are of immense interest. Apart from the undoubted role of hyperglycaemia, the importance of genetic determinants of neph ropathy has recently been recognized. Factors of proven or suspected e fficacy in attenuating progression include: hypertension, hyperglycaem ia, smoking and proteinuria. The role of dietary protein intake is les s well documented. Nephropathy in type II diabetes has become the sing le most common cause of end-stage renal failure in Germany and is toda y a major challenge to clinical nephrology.