Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2012     Vol 37     No 2
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      UDK 616.61-084:616.379-008.64

ISSN 035-2899, 37(2012) No 2 p.101-109

Review articles

Prevention of Diabetic Nephropathy
(Prevencija dijabetesne nefropatije)

Jelena Pantelić


Diabetic nephropathy (DN) occurs in 20–40% of patients with diabetes and is the single leading cause of the end-stage renal disease (ESRD). Persistent albuminuria in the range of 30–300mg/24h (microalbuminuria) has been shown to be the stage of incipient diabetic nephropathy in type 1 and in type 2 diabetes. Microalbuminuria is also a well-established marker of increased cardiovascular disease risk. Patients with microalbuminuria who progress to macroalbuminuria (≥ 300 mg/24 h) are likely to progress to ESRD over a period of years. Prevention of diabetes nephropathy has been shown to retard glomerular filtration rate (GFR) decline in the early stage of diabetes nephropathy – the prevention measures are glyceamic control, blood pressure reduction, angiotensin-converting enzyme inhibition, angiotensin receptor antagonism, calcium channel blockade, cholesterol reduction, smoking cessation, erythropoetin therapy and dietary protein restriction. The fact is that the opportunity for the preservation of renal function is the greatest when the intervention is instigated at an early stage. However, the early stage of diabetes nephropathy is frequently unrecognized and accompanied by multiple associated comorbidities including hypertension, renal osteodystrophy, anaemia, sleep apnoea, cardiovascular disease, hyperparathyroidism and malnutrition. Early treatment of these complications of diabetes could considerably postpone the outcomes of diabetes nephropathy.
Key words: prevention, diabetes, nephropathy

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian

      Corresponding Address:
Jelena Pantelić
Dom zdravlja Smederevska Palanka
Kneza Miloša 4, Smederevska Palanka
e-mail :
Paper received: 28.8.2012
Paper accepted: 23.9.2012
Paper Internet issues: 12.11.2012
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Timočki medicinski glasnik, Zdravstveni centar Zaječar
Journal of Regional section of Serbian medical association in Zajecar
Rasadnička bb, 19000 Zaječar, Srbija

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