Endocrinologie et syndrome métabolique
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Role of Diabetes and Blood Pressure in the Advancement of Renal Disease

Chaudhary MJ Nazar, Bojerenu M Mauton and Manzoor A Lala

Bulk of the kidney disease in diabetic patient are associated with nephropathy complications. Hypertension is usually found in chronic type 1 and type 2 diabetes sufferers. Numerous factors like vascular remodelling, basement membrane thickening, vascular atherosclerosis, mesangial cell proliferation, oxidative stress in renal apparatus due to ischemia etc. due to both the hypertension and hyperglycemia leads to expansion and evolution of nephropathy in these patients. Management of hypertension is therefore highly advisable in diabetes patient as an important intervention to prevent vascular damages like nephropathy. The aim of hypertensive drug management in diabetic patient should include both the management of blood pressure as well as albuminuria management. ACE inhibitors are found to be the most appropriate drugs which complies to both these requirement while the use of other antihypertensive drugs require caution due to their derogatory influences on the glucose and lipid metabolism in diabetic patients.