DIABETIC NEPHROPATHY PPT-FOR NEPHRO URO SPECIALITY

1. Diabetic nephropathy
 PRESENTATION BY
 RAJESH.M
 2nd YEAR MSC NURSING
 CITY COLLEGE OF NURSING
SHAKTINAGAR MANGALORE

2. Diabetic nephropathy

3. Other terminologies
 Kimmelstiel-wilson syndrome
 Nodular diabetic glomerulosclerosis
 Intercapillary glomerlonephritis

4. History
 Discovered by
british physician –clifford wilson
and
german-born american physician paul
kimmelstiel

5. Definition
Diabetic nephropathy is a
microvascular complication
assosiated with damage to the small
blood vessel that supply the glomeruli
of the kidney

6. Incidence
 About 35-45% of client with type 1 diabetes are found
to have nephropathy 15 to 20 yr after diagnosis
 About 20% of client with type 2 diabetes are found to
have nephropathy 5 to 10 years after diagnosis

7. Risk factors and etiology
 Family history
 Person with type 1 diabetes that started before age 20
 People of african-american,american indian
orgin,hispanic
 Type 1 and 2 diabetes
 Genetic predisposition
 Smoking
 Chronic hyperglycemia

8.  Person with poor control of
blood glucose
blood pressure
cholestrol level

9. Pathophysiology
Etiological factors
Thickening of the glomerulus
microalbuminuria

12. Signs and symptoms
 Increased blood pressure
 Foamy appearance or excessive frothing of the urine
 Unintentional weight gain
 Edema----swelling around eyes in the morning.
-----general body swelling may result such as swelling
of the legs

13. Anrexia
Nausea and
vomiting
Malaise, fatigue
Headache
Frequent hiccups
Generalised
itching

14. Diagnostic evaluation
 History collection
 Physical examination
 Blood test-BUN,creatinine
 24 hr urine protein
 Blood level of phosporous , ca,bicarbonate, PTH
and pottassium,hb,hematocrit
Protein electrophoresis-urine
Kidney biopsy

15. Complication
 Rapidly progressive kidney failure
 End stage kidney failure
 Hyperkalemia
 Severe hypertension
 Complication of kidney transplant
 Coexistence of other diabetic complication
 Peritonitis
 Increased infection

16. Management

17. MEDICAL MANAGEMENT
 Control of hyperglycemia
 Antihypertensive
 Diet management
 Avoid nephrotoxic drugs,NSAIDS

18.  Dialysis
 peritoneal or hemodialysis
 Kidney transplantation
 C-peptide ,a by product of insuline production

19. Nursing management