1. Diabetic Nephropathy- The most common cause ofDiabetic Nephropathy- The most common cause of Chronic Kidney Disease (CKD) ? Chronic Kidney Disease (CKD) ? First Author: Kovács ZoltánFirst Author: Kovács Zoltán Coauthor: Gyerő RékaCoauthor: Gyerő Réka Coordinator: Dr. Mathé LehelCoordinator: Dr. Mathé Lehel

2. Hyperglycemia in the long term causes hemodynamical changes in the microcirculation of the kidneys, membrana basalis thickening, increase in the volume of the extracelular matrix, mesangial expansion, fibrosis. These form the Kimmelstiel-Wilson syndrome. It is characterized by diffuse or nodular glomerulosclerosis afferent and efferent hyaline aterosclerosis, leading progressively towards renal failure.

3. Objective: Verifying if the most common cause of Chronic Kidney disease (CKD) in patients with diabetes is Diabetic Nephropathy, respectively what other factors can be taken into account as triggers of renal damage, and Chronic Kidney Disease (CKD).

4. Material and Method: Retrospective study involving 100 patients suffering from both Diabetes Mellitus and Chronic Kidney disease. Patients are from the Mures and Covasna counties in Romania. Patients who are in stage 1 of CKD are excluded from this study because at this stage diagnosis is difficult; patient is asymptomatic, proteinuria and a rise in creatinin may indicate it however. In order to remove inaccuracies we chose to ignore those cases and focus on patients in more advanced stages.

5. In 68 % of the patients the cause of Chronic Kidney Disease was Diabetic Nephropathy. In 13% of the patients the trigger was an infection. (1% of the patients have renal TB) In 10% of the patients the trigger was a combination of hypertension and nephrosclerosis In 6% of the patients the trigger was obstructive Nephropathy. In 2% of the patients myeloma was the cause of renal damage. In 1% of the patients gout was the cause of renal damage.

7. The patients can be divided according to which region they are treated in.The patients can be divided according to which region they are treated in. This study includes 52 patients in the Covasna countyThis study includes 52 patients in the Covasna county and 48 patients in Mures countyand 48 patients in Mures county Covasna county Mures county Diabetic Nephropathy-glomerulosclerosis67,31%68,75% Infective11,54%14,58% Mixed: Nephroangiosclerosis+ hypertensive7,69%12,50% Obstructive nephropathy9,62%2,08% Nephropathy due to multiple myeloma1,92%2,08% Renal damage caused by gout1,92%0%

11. If we were to examine the patients according to diabetes typeIf we were to examine the patients according to diabetes type we would get the following chartwe would get the following chart Patients suffering of type 1 diabetes : 23% Patients suffering from insulin dependent type 2 diabetes: 46% Patients suffering from non insulin dependent type 2 diabetes: 31%

12. Patients suffering of type 1 diabetes : 29,41% Patients suffering from insulin dependent type 2 diabetes: 50% Patients suffering from non insulin dependent type 2 diabetes: 20,59% We can also create this chart to illustrate the distribution of different types of diabetes in patients with Diabethic Nephropathy-glomerulosclerosis.

13. Our study has shown that Diabetic Nephropathy is the most significant trigger of Chronic Kidney Disease (CKD) in patients with diabetes. Other triggers such as infection(pyelonephritis), and obstructive nephropathy have proven to be a lot less frequent.

14. Conclusions: In patients suffering from Diabetes mellitus the most common cause of Chronic Kidney Disease (CKD) is Diabetic Nephropathy- also known as Kimmelstiel-Wilson syndrome.

15. My own work:My own work: -Gathering patient data-Gathering patient data -Calculation and interpretation of the results-Calculation and interpretation of the results -Creating charts and tables-Creating charts and tables