Epidemiology and pathophysiological mechanisms involved in alteration of glomerular function in diabetic patients

Chronic kidney disease of diabetic cause is a highly prevalent complication in diabetes mellitus patients. Complex phenotypes of the disease start to be recognized, such as albuminuria (micro- or macroalbuminuria) and non-albuminuric phenotype reduced glomerular filtration rate <60 mL/min/1.73m2. Numerous pathogenic pathways contribute to the development of this disorder, as follows: the alterations of glucose metabolism with excess degradation of glucose on alternative pathways, hemodynamic changes, glomerulosclerosis, inflammation. As this review demonstrates once more, all these pathophysiological modifications can be linked to hyperglycaemia. Both glomerular and tubular interstitial lesions occur and contribute to disease progression. Adequate glycaemic control and an early diagnosis of diabetes mellitus are key measures in preventing this complication.