Diabetic Nephropathy & Hypertension

Diabetic nephropathy is characterized by hypertension, progressive albuminuria, glomerulosclerosis, and decline in glomerular filtration rate (GFR) leading to ESRD. Hypertension in the setting of diabetes is defined as a systolic blood pressure ≥ 130 mmHg or a diastolic blood pressure ≥ 80 mmHg. An elevated urinary albumin excretion rate, increased blood pressure (BP), and a continual loss of renal function are characteristics of DN. Screening for micro albuminuria is central to diabetes care, and antihypertensive agents are used for the primary prevention and treatment of DN. Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers play central roles and have protective properties beyond their BP-lowering effects. BP control in relation to DN is the main focus of this review, but tight control of the glucose level is equally important.

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