How does Diabetic nephropathy increase GFR?

[Osteoth]

First Aide 2017 page 566 at the bottom.

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[ZKenpachi]

Nonenzymatic glycosylation of vascular basement membrane leads to hyaline arteriolosclerosis (narrow lumen). For some reason it involves the efferent arterioles more than the afferents, increasing the glomerular filtration pressure and GFR.

This is why ACE inhibitors are protective in diabetic nephropathy; they dilate the efferent arterioles.

 

[cellsaver]

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[yankees527]

You do realize that when there is renal disease, GFR declines, right? GFR does not increase when the kidneys are failing.
GFR declines even in "normal" kidney function by virtue of the aging process

Perhaps you should put down FA and study the textbook in medical physiology that your medical school requires you to study.

Wow you're a troll. Maybe instead of being a cocky troll you should be picking up the books.

GFR actually does increase, as explained by @ZKenpachi

"Approximately one-half of patients with type 1 diabetes of less than five years duration have an elevated glomerular filtration rate (GFR) that is 25 to 50 percent above normal. "
-Direct quote from Uptodate in case you dont believe him.

 

[cellsaver]

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[dfib slim]

Glomerular hyperfiltration: a marker of early renal damage in pre-diabetes and pre-hypertension | Nephrology Dialysis Transplantation | Oxford Academic

GFR initially increases then progressively decreases.

"Increased glomerular capillary hydraulic pressure may be due to changes in systemic arterial pressure and/or changes in efferent and afferent arteriolar resistances. In the absence of therapeutic interventions, GFR then falls progressively in parallel with a further rise in albuminuria which may lead, in the long run, to end-stage renal failure."

 

[nidusiamnot]

Glomerular hyperfiltration: a marker of early renal damage in pre-diabetes and pre-hypertension | Nephrology Dialysis Transplantation | Oxford Academic

GFR initially increases then progressively decreases.

"Increased glomerular capillary hydraulic pressure may be due to changes in systemic arterial pressure and/or changes in efferent and afferent arteriolar resistances. In the absence of therapeutic interventions, GFR then falls progressively in parallel with a further rise in albuminuria which may lead, in the long run, to end-stage renal failure."

Exactly, cellsaver I don't think anyone is arguing that the end result is a stepwise decrease in renal function as observed by the very late drop in GFR. The premise for the question considering the fact that there is hyper filtration in the early stages of the disease by the mechanism described above. I hope this clarifies any misconceptions you had about the question.

 

[Osteoth]

Well this got contentious fast.

Anyhow, thanks for the help everyone, I think we've all learned something today.

 

[cellsaver]

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[cellsaver]

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[yankees527]

says the slackard who asked this gem



pick up a textbook yourself. FA obviously isnt helping you but then again, ask me if care.

You seem like one of those people who bash others for asking questions and admitting their doubts. Maybe you're the one who needs to take a step back and think about your own insecurities.