Chronic renal disease (CRD) has been considered to be irreversible (1). Renal fibrosis, a histological diagnosis of end-stage CRD, is characterized by a loss of renal parenchymal cells that are replaced by extracellular matrix (ECM) proteins, a common final pathway leading to renal dysfunction (1,2). The number of patients affected with CRD is on the increase, and dialysis market estimates indicate that more than 1 million patients worldwide have undergone maintenance dialysis. Thus, many nations are burdened with social and financial problems associated with funding health services for the dialysis of CRD patients (3). Diabetes is now the leading cause of end-stage renal disease (ESRD) in many developed countries, and diabetic nephropathy (DN) has emerged as a silent epidemic worldwide (2,3). This is certainly the case in Japan, in which diabetic kidney disease accounted for 35% of all new patients undergoing dialysis in 2003. To maintain replacement therapy, it now costs nearly $10 million per year in Japan for public financial support. Likewise, in the United States, DN accounted for 35% of all new cases of ESRD in 1997. The physical and monetary costs of diabetic kidney disease to both the patient and society are now enormous.
Histopathologically, DN is characterized by glomerular hypertrophy, followed by sclerotic lesions, in which ECM protein is overaccumulated in the mesangial interstitium (3).
From: Contemporary Diabetes: The Diabetic Kidney Edited by: P. Cortes and C. E. Mogensen © Humana Press Inc., Totowa, NJ
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...