【Risk Factors of Diabetic Nephropathy】

Diabetic nephropathy develops in, at most, 40% of patients with diabetes, even when high glucose levels are maintained for long periods of time. This observation raised the concept that a subset of patients have an increased susceptibility to diabetic nephropathy. Furthermore, epidemiological and familial studies have demonstrated that genetic susceptibility contributes to the development of diabetic nephropathy in patients with both type 1 and type 2 diabetes. The main potentially modifiable diabetic nephropathy initiation and progression factors in susceptible individuals are sustained hyperglycemia and hypertension. Other putative risk factors are glomerular hyperfiltration, smoking, dyslipidemia, proteinuria levels, and dietary factors, such as the amount and source of protein and fat in the diet.