Diabetic nephropathy in the elderly.
Although diabetes is clearly linked to macro- and microvasculopathy in multiple organs resulting in cardiovascular and cerebrovascular catastrophic diseases, blindness, and limb amputations, it is the relentless progression of diabetic nephropathy toward becoming the major cause of end-stage renal disease (ESRD) that now challenges budgets and treatment facilities providing hemodialysis, peritoneal dialysis, and kidney transplantation. Nephrology, as a specialty, is now dominated by the necessity to address geriatrics and endocrinology to cope with the tidal wave of elderly ESRD patients suffering from uremia caused by diabetes. On the brighter side, emergence of effective renoprotective regimens now slow the incidence rate of ESRD in those with diagnosed diabetes. There is bona fide reason to hope that within a decade, kidney failure attributable to diabetes will be transformed into a preventable complication of a disease that has dominated and directed our heritage.
Joseph
Anthony J
AJ
Department of Medicine, Renal Division, Downstate Medical Center, 450 Clarkson Avenue, Box 52, Brooklyn, NY 11203, USA. anjjoseph@netscape.net
Friedman
Eli A
EA
D000367:Age Factors; D000368:Aged; D001706:Biopsy; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D018753:Diet, Protein-Restricted / Q000379:methods*; D018450:Disease Progression; D014943:Global Health; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008019:Life Style; D009017:Morbidity; D011379:Prognosis; D017582:Renal Replacement Therapy / Q000379:methods*
D007004:Hypoglycemic Agents