[Diabetic nephropathy. I].

Abstract

The paper reports on the present knowledge in the diabetic nephrosis (DN) with emphasis on three problems: evolution by stages, possibility of detecting the diabetics with high risk of developing clinic DN, and the prophylactic and therapeutic measures required for a resting or, at least, for slowing down the evolution of this complication. The functional changes, manifested mainly by increasing the glomerular filtration, are detected in many insulin-dependent diabetics even from the diagnosis of the disease and they are predictive elements for the clinic DN; that is the reason why they must be reduced by a correct and prolonged control. Microalbuminuria, defined as a urinary excretion of albumin of less than 250 mg/24 hours (18-74 micrograms/minute) is another characteristic of the precocious stages of the DN. Exceeding the above-mentioned values means the transition to the clinic DN, that subsequently progresses in all cases. The paper also describes the characteristics of the clinic DN and the therapeutic ways both in the incipient and clinic DN, with emphasis on their features in the diabetes mellitus and its complications.