Endocrine & metabolic · UKMLA & AKT
Diabetic nephropathy
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise diabetic nephropathy — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Chronic hyperglycaemia → RAAS activation → afferent arteriole dilation → raised intraglomerular pressure → glomerular hyperfiltration
- Early disease: kidneys are bilaterally enlarged due to hyperfiltration and hypertrophy - the opposite of most CKD causes
- Late disease: kidneys return to normal size then atrophy as glomerulosclerosis progresses
On ultrasound, bilaterally enlarged kidneys in a diabetic patient = diabetic nephropathy (early). Other causes of enlarged kidneys: polycystic kidney disease, amyloidosis, HIV nephropathy. Shrunken kidneys are NOT a feature of early diabetic nephropathy.
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