Progression and Nonprogression of Chronic Renal Failure in Diabetic Nephropathy: Which Factors are Determinants?

  • Gudrun Nyberg
Part of the Topics in Renal Medicine book series (TIRM, volume 6)


In the past, the outlook for diabetic patients who developed persistent proteinuria was poor. More than 60% died within 10 years [1], most of them from uremia, because renal replacement therapy (RRT) was not available. The spontaneous rate of progression was shown to vary widely between individuals, but tended to be constant in each subject [2–4]. Jones et al. [3] reported that once serum creatinine had reached 200 μmol/liter the inversed values showed a linear correlation with time. This has been accepted by many authors as a fact valid for the whole range of renal function and during intervention, but it has serious limitations. As stressed by Myer’s group [5], glomerular function should be measured using a true filtration marker. In studies based on such measurements of glomerular filtration rate (GFR), no significant correlation was found between GFR decline and inverse creatinine slope coefficients [4]. An average figure for spontaneous fall rate was about 1 ml/min per month, but the values ranged from 0.13 to 2.47 [3, 4, 6], which is 1.629.6 ml/min per year.


Glomerular Filtration Rate Diabetic Nephropathy Protein Intake Continuous Subcutaneous Insulin Infusion Supine Blood Pressure 
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© Springer Science+Business Media Dordrecht 1988

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  • Gudrun Nyberg

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