Diabetic nephropathy. A perspective

Michael Mauer, Michael W Steffes, F. C. Goetz, D. E. Sutherland, D. M. Brown

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations


The earliest manifestations of clinical diabetic nephropathy, including proteinuria, hypertension, and declining GFR, represent very advanced diabetic glomerulopathy with especially prominent mesangial expansion. Mesangial expansion, by restricting glomerular capillary filtration surface and lumenal volume, stimulates compensatory mechanisms analogous to those resulting from a marked reduction in nephron number. These compensatory mechanisms involve alterations in glomerular hemodynamics designed to maintain glomerular filtration but which ultimately injure the kidney. These hemodynamic perturbations are not specific to diabetes but represents a final common pathway toward endstage renal failure that also characterizes the remnant kidney. This thesis concludes that the onset of clinical diabetic nephropathy augurs inevitable decline in kidney function, and that only studies and interventions exercised before clinical nephropathy develops can influence understanding and outcome of diabetic nephropathy.

Original languageEnglish (US)
Pages (from-to)52-55
Number of pages4
JournalUnknown Journal
Issue number2 II Suppl.
StatePublished - 1983


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